Remotely-executed medical therapy device

ABSTRACT

Described are systems for providing remote medical therapy to a subject by dispensing one or more medical items from a short-term inventory of medical items. The inventory of medical items is risk profiled based on probability calculation of health or economic risk to a subject, a population, a venue, or a situation in advance of need for the medical items. In some embodiments, the system comprises a digital processing device, an apparatus for dispensing the one or more medical items, and a connector device, with a memory, that facilitates communication between the digital processing device and the dispensing apparatus.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Application Ser. No.61/767,956, filed Feb. 22, 2013, U.S. Application Ser. No. 61/810,269,filed Apr. 10, 2013, and U.S. Application Ser. No. 61/826,348, filed May22, 2013, each of which is hereby incorporated by reference in itsentirety.

BACKGROUND OF THE INVENTION

A wide variety of circumstances result in inadequate access tohealthcare for many individuals and families. Some lack adequate accessbecause they live in isolated, rural, or other governmentally designatedunderserved areas. Some lack adequate access because they are uninsuredor underinsured. Others live in developing countries where medicaltraining and infrastructure is yet to be developed. Circumstances rendersome individuals without adequate access to healthcare in natural andmanmade disaster areas and battlefields.

Moreover, the cost of providing adequate healthcare is rising. Whilemore money is spent on health care per person in the U.S. than in anyother nation in the world, in 2009, the U.S. Census Bureau reported that16.7% of the population was uninsured. Current estimates put U.S. healthcare spending at approximately 16% of GDP. Growth in healthcare spendingis projected to average 6.7% annually over the period 2007 through 2017.High healthcare costs also affect individuals. A 2007 study found that62.1% of filers for bankruptcy cited high medical expenses as acontributing factor.

BRIEF SUMMARY OF THE INVENTION

Described are systems for providing remote medical therapy to a subjectby dispensing one or more medical items from a short-term inventory ofmedical items. The inventory of medical items is risk profiled based onprobability calculation of health or economic risk to a subject, apopulation, a venue, or a situation in advance of need for the medicalitems. In some embodiments, the system comprises a digital processingdevice, an apparatus for dispensing the one or more medical items, and aconnector device, with a memory, that facilitates communication betweenthe digital processing device and the dispensing apparatus.

EXEMPLARY EMBODIMENTS

In one aspect, disclosed herein are devices for providing remote medicaltherapy to a subject in a healthcare encounter, the device comprising aprocessor and a memory device, the device further comprising: a housing;at least one means for communicating with an apparatus for dispensingone or more medical items from an inventory of medical items, theinventory of medical items risk profiled to a subject, a population, avenue, an event, or a situation; at least one means for communicatingwith a technology device; and a software module enabling communicationsbetween the apparatus for dispensing one or more medical items from aninventory of medical items and the technology device. In someembodiments, the device further comprises a magnetic stripe reader. Infurther embodiments, the magnetic stripe reader is adapted to read dataon a magnetic stripe associated with an insurance card, financialtransaction card, membership card, or the apparatus for dispensing oneor more medical items from an inventory of medical items. In furtherembodiments, the at least one means for communicating with an apparatusfor dispensing one or more medical items from an inventory of medicalitems is a magnetic stripe reader. In some embodiments, the at least onemeans for communicating with an apparatus for dispensing one or moremedical items from an inventory of medical items is a connector selectedfrom: data port, audio jack, microphone jack, Ethernet, FireWire,mini-USB, micro-USB, USB Type A, and USB Type B. In further embodiments,the connector is reversibly retractable within the housing. In furtherembodiments, the connector swivels about an axis with respect to thehousing. In some embodiments, the at least one means for communicatingwith an apparatus for dispensing one or more medical items from aninventory of medical items is a wireless interface selected from:Bluetooth, ZigBee, Wi-Fi, near field communication, radio-frequencyidentification, and infrared. In some embodiments, the device furthercomprises a confirmation component, the confirmation componentindicating if a correct apparatus for dispensing one or more medicalitems is in communication with the device. In further embodiments, theconfirmation component provides visual confirmation, audibleconfirmation, tactile confirmation, or a combination thereof. In someembodiments, the technology device is a computer, a mobile device, ahard wired telephone, a set top box, an internet appliance, or medicaldiagnostic device. In some embodiments, the technology device is anetworked device including a software module for securely accessing oneor more electronic health records for the subject. In some embodiments,the at least one means for communicating with a technology device is aconnector selected from: data port, audio jack, microphone jack,Ethernet, FireWire, mini-USB, micro-USB, USB Type A, and USB Type B. Infurther embodiments, the connector is reversibly retractable within thehousing. In further embodiments, the connector swivels about an axiswith respect to the housing. In some embodiments, the at least one meansfor communicating with a technology device is a wireless interfaceselected from: Bluetooth, ZigBee, Wi-Fi, near field communication,radio-frequency identification, and infrared. In some embodiments, thedevice further comprises a software module for remote monitoring oroperation of the device by a telemedical care provider. In furtherembodiments, the telemedical care provider is selected from the groupconsisting of: a physician, a pharmacist, a dentist, a physicianassistant, a nurse practitioner, a registered nurse, a pharmacist, achiropractor, an emergency medical technician, a licensed practicalnurse, a certified ultrasound technician, a psychologist, a socialworker, a military medic, a physical therapist, an occupationaltherapist, a speech therapist, a radiology technician, a cardiaccatheterization technician, a clinical pathology laboratory technician,a medical aesthetician, a licensed medical technologist, a toxicologistconsultant, a credentialed medical legal consultant, a credentialedhospital operations administrator, veterinarian or a veterinary nurse,assistant, or technician. In further embodiments, the telemedical careprovider is the subject's primary care physician. In furtherembodiments, the subject's primary care physician selects at least oneadjunct healthcare provider identified or selected based on one or moreof: type of patient's condition, severity of patient's condition,patient's insurance eligibility, and availability of one or more adjuncthealthcare providers. In still further embodiments, the at least oneadjunct healthcare provider is credentialed by the subject's primarycare provider to provide: remote diagnosis and therapy, telemedicalservices, urgent care services, outpatient services, acute careservices, pharmacy services, insurance services to the subject, or acombination thereof. In some embodiments, the device further comprises asoftware module enabling the selection of at least one adjuncthealthcare provider from a database of healthcare providers to becredentialed by the subject's primary care physician for providing:remote diagnosis and therapy, telemedical services, urgent careservices, outpatient services, acute care services, pharmacy services,insurance services to the subject, or a combination thereof. In someembodiments, the device further comprises a software module foridentifying a subject. In some embodiments, the device further comprisesa biosensor. In further embodiments, the biosensor is adapted to collectmedical information from a subject or the subject's environment. In someembodiments, the inventory of medical items is determined by profilinghealth or economic risk for a subject, a population, a venue, an event,or a situation in advance of need for the medical items. In furtherembodiments, the inventory of medical items is risk profiled bydetermining a statistical level of likelihood that the items will beneeded within 2 years, within 1 year, within 6 months, within 1 month,within 2 weeks, within 1 week, or within 1 day. In further embodiments,risk profiling analysis comprises performing statistical analysis,performing probability calculations, making recommendations, and makingoutcome predictions to predict a health or economic outcome of a patientor therapy, wherein said prediction is real-time, individualized, andprobabilistic-based and uses historic, peer-reviewed health or economicdata and emerging health or economic data. In some embodiments, theinventory of medical items comprises items that require a prescriptionfrom a licensed healthcare provider. In further embodiments, theinventory of medical items comprises: one or more medications, one ormore therapeutic devices, one or more diagnostic devices, or one or morediagnostic kits.

In another aspect, disclosed herein are systems for providing remotemedical therapy to a subject in a healthcare encounter, the systemcomprising: an apparatus for dispensing one or more medical items froman inventory of medical items, the inventory of medical items riskprofiled to a subject, a population, a venue, or a situation; and aconnector device comprising: a processor; a memory; at least one meansfor communicating with the apparatus for dispensing one or more medicalitems from an inventory of medical items; at least one means forcommunicating with a technology device; and a software module enablingcommunications between the apparatus for dispensing one or more medicalitems from an inventory of medical items and the technology device. Insome embodiments, the apparatus for dispensing one or more medical itemsfrom an inventory of medical items comprises a magnetic stripe reader.In further embodiments, the magnetic stripe reader reads data on amagnetic stripe associated with an insurance card, financial transactioncard, membership card, or the connector device. In some embodiments, theconnector device or the technology device comprises a software modulefor providing instantaneous encounter-specific financial insurancecoverage, wherein said insurance includes a level of guarantee and anassociated premium. In further embodiments, the connector device or thetechnology device comprises a software module for processing payment. Insome embodiments, the apparatus for dispensing one or more medical itemsfrom an inventory of medical items comprises one or more tamper-proof orchild-proof elements. In further embodiments, the apparatus fordispensing one or more medical items from an inventory of medical itemscomprises a removable, opaque sleeve. In further embodiments, theapparatus for dispensing one or more medical items from an inventory ofmedical items comprises a tamper-proof or child-proof opening mechanism.In further embodiments, the apparatus for dispensing one or more medicalitems from an inventory of medical items comprises a tamper-proof orchild-proof protective wrapper. In some embodiments, the connectordevice comprises a magnetic stripe reader. In further embodiments, themagnetic stripe reader is adapted to read data on a magnetic stripeassociated with an insurance card, financial transaction card,membership card, or the apparatus for dispensing one or more medicalitems from an inventory of medical items. In some embodiments, the atleast one means for communicating with an apparatus for dispensing oneor more medical items from an inventory of medical items is a magneticstripe reader. In some embodiments, the at least one means forcommunicating with an apparatus for dispensing one or more medical itemsfrom an inventory of medical items is a connector selected from: dataport, audio jack, microphone jack, Ethernet, FireWire, mini-USB,micro-USB, USB Type A, and USB Type B. In further embodiments, theconnector is reversibly retractable within the housing. In furtherembodiments, the connector swivels about an axis with respect to thehousing. In some embodiments, the at least one means for communicatingwith an apparatus for dispensing one or more medical items from aninventory of medical items is a wireless interface selected from:Bluetooth, ZigBee, Wi-Fi, near field communication, radio-frequencyidentification, and infrared. In some embodiments, the connector devicefurther comprises a confirmation component, the confirmation componentindicating if a correct apparatus for dispensing one or more medicalitems is in communication with the device. In further embodiments, theconfirmation component provides visual confirmation, audibleconfirmation, tactile confirmation, or a combination thereof. In someembodiments, the technology device is a computer, a mobile device, ahard wired telephone, a set top box, an internet appliance, or a medicaldiagnostic device. In some embodiments, the technology device is anetworked device including a software module for securely accessing oneor more electronic health records for the subject. In some embodiments,the at least one means for communicating with a technology device is aconnector selected from: data port, audio jack, microphone jack,Ethernet, FireWire, mini-USB, micro-USB, USB Type A, and USB Type B. Infurther embodiments, the connector is reversibly retractable within thehousing. In further embodiments, the connector swivels about an axiswith respect to the housing. In some embodiments, the at least one meansfor communicating with a technology device is a wireless interfaceselected from: Bluetooth, ZigBee, Wi-Fi, near field communication,radio-frequency identification, and infrared. In some embodiments, theconnector device or the technology device comprises a software modulefor remote monitoring or operation of the device by a telemedical careprovider. In further embodiments, the telemedical care provider isselected from the group consisting of: a physician, a pharmacist, adentist, a physician assistant, a nurse practitioner, a registerednurse, a pharmacist, a chiropractor, an emergency medical technician, alicensed practical nurse, a certified ultrasound technician, apsychologist, a social worker, a military medic, a physical therapist,an occupational therapist, a speech therapist, a radiology technician, acardiac catheterization technician, a clinical pathology laboratorytechnician, a medical aesthetician, a licensed medical technologist, atoxicologist consultant, a credentialed medical legal consultant, acredentialed hospital operations administrator, veterinarian or aveterinary nurse, assistant, or technician. In further embodiments, thetelemedical care provider is the subject's primary care physician. Instill further embodiments, the subject's primary care physician selectsat least one adjunct healthcare provider identified or selected based onone or more of: type of patient's condition, severity of patient'scondition, patient's insurance eligibility, and availability of one ormore adjunct healthcare providers. In still further embodiments, the atleast one adjunct healthcare provider is credentialed by the subject'sprimary care provider to provide: remote diagnosis and therapy,telemedical services, urgent care services, outpatient services, acutecare services, pharmacy services, insurance services to the subject, ora combination thereof. In some embodiments, the connector device or thetechnology device further comprises a software module enabling theselection of at least one adjunct healthcare provider from a database ofhealthcare providers to be credentialed by the subject's primary carephysician for providing: remote diagnosis and therapy, telemedicalservices, urgent care services, outpatient services, acute careservices, pharmacy services, insurance services to the subject, or acombination thereof. In some embodiments, the connector device or thetechnology device comprises software module for identifying a subject.In some embodiments, the connector device or the technology devicecomprises a biosensor. In further embodiments, the biosensor is adaptedto collect medical information from a subject or the subject'senvironment. In some embodiments, the inventory of medical items isdetermined by profiling health or economic risk for a subject, apopulation, a venue, an event, or a situation in advance of need for themedical items. In further embodiments, the inventory of medical items isrisk profiled by determining a statistical level of likelihood that theitems will be needed within 2 years, within 1 year, within 6 months,within 1 month, within 2 weeks, within 1 week, or within 1 day. Infurther embodiments, risk profiling analysis comprises performingstatistical analysis, performing probability calculations, makingrecommendations, and making outcome predictions to predict a health oreconomic outcome of a patient or therapy, wherein said prediction isreal-time, individualized, and probabilistic-based and uses historic,peer-reviewed health or economic data and emerging health or economicdata. In some embodiments, the inventory of medical items comprisesitems that require a prescription from a licensed healthcare provider.In further embodiments, the inventory of medical items comprises: one ormore medications, one or more therapeutic devices, one or morediagnostic devices, or one or more diagnostic kits.

In another aspect, disclosed herein are devices for providing remotemedical therapy to a subject in a healthcare encounter, the devicecomprising a processor and a memory device, the device furthercomprising: a housing; a communications connection for communicatingwith an apparatus for dispensing one or more medical items from aninventory of medical items, the inventory of medical items risk profiledto a subject, a population, a venue, an event, or a situation; acommunications connection for communicating with a technology device,the technology device comprising a software module for remote monitoringor operation of the device by a telemedical care provider; a softwaremodule enabling communications between a connected apparatus fordispensing one or more medical items from an inventory of medical itemsand a connected technology device; and a confirmation component, theconfirmation component indicating if the correct apparatus fordispensing one or more medical items is in communication with thedevice. In some embodiments, the device further comprises a magneticstripe reader, the magnetic stripe reader within a slot of the housing.In further embodiments, the magnetic stripe reader is adapted to readdata on a magnetic stripe associated with an insurance card, financialtransaction card, membership card, or the apparatus for dispensing oneor more medical items from an inventory of medical items. In someembodiments, the communications connection for communicating with anapparatus for dispensing one or more medical items from an inventory ofmedical items is a magnetic stripe reader. In some embodiments, thecommunications connection for communicating with an apparatus fordispensing one or more medical items from an inventory of medical itemsis a connector selected from: data port, audio jack, microphone jack,Ethernet, FireWire, mini-USB, micro-USB, USB Type A, and USB Type B. Infurther embodiments, the connector is reversibly retractable within thehousing. In further embodiments, the connector swivels about an axiswith respect to the housing. In some embodiments, the communicationsconnection for communicating with an apparatus for dispensing one ormore medical items from an inventory of medical items is a wirelessinterface selected from: Bluetooth, ZigBee, Wi-Fi, near fieldcommunication, radio-frequency identification, and infrared. In someembodiments, the confirmation component provides visual confirmation,audible confirmation, tactile confirmation, or a combination thereof. Insome embodiments, the technology device is a computer, a mobile device,a hard wired telephone, a set top box, or medical diagnostic device. Insome embodiments, the technology device is a networked device includinga software module for securely accessing one or more electronic healthrecords for the subject. In some embodiments, the communicationsconnection for communicating with a technology device is a connectorselected from: data port, audio jack, microphone jack, Ethernet,FireWire, mini-USB, micro-USB, USB Type A, and USB Type B. In furtherembodiments, the connector is reversibly retractable within the housing.In further embodiments, the connector swivels about an axis with respectto the housing. In some embodiments, the communications connection forcommunicating with an apparatus for dispensing one or more medical itemsfrom an inventory of medical items is a wireless interface selectedfrom: Bluetooth, ZigBee, Wi-Fi, near field communication,radio-frequency identification, and infrared. In some embodiments, thetelemedical care provider is selected from the group consisting of: aphysician, a pharmacist, a dentist, a physician assistant, a nursepractitioner, a registered nurse, a pharmacist, a chiropractor, anemergency medical technician, a licensed practical nurse, a certifiedultrasound technician, a psychologist, a social worker, a militarymedic, a physical therapist, an occupational therapist, a speechtherapist, a radiology technician, a cardiac catheterization technician,a clinical pathology laboratory technician, a medical aesthetician, alicensed medical technologist, a toxicologist consultant, a credentialedmedical legal consultant, a credentialed hospital operationsadministrator, veterinarian or a veterinary nurse, assistant, ortechnician. In some embodiments, the telemedical care provider is thesubject's primary care physician. In further embodiments, the subject'sprimary care physician selects at least one adjunct healthcare provideridentified or selected based on one or more of: type of patient'scondition, severity of patient's condition, patient's insuranceeligibility, and availability of one or more adjunct healthcareproviders. In still further embodiments, the at least one adjuncthealthcare provider is credentialed by the subject's primary careprovider to provide: remote diagnosis and therapy, telemedical services,urgent care services, outpatient services, acute care services, pharmacyservices, insurance services to the subject, or a combination thereof.In some embodiments, the device further comprises a software moduleenabling the selection of at least one adjunct healthcare provider froma database of healthcare providers to be credentialed by the subject'sprimary care physician for providing: remote diagnosis and therapy,telemedical services, urgent care services, outpatient services, acutecare services, pharmacy services, insurance services to the subject, ora combination thereof. In some embodiments, the device further comprisessoftware module for identifying a subject. In some embodiments, thedevice further comprises a biosensor. In further embodiments, thebiosensor is adapted to collect medical information from a subject orthe subject's environment. In some embodiments, the inventory of medicalitems is determined by profiling health or economic risk for a subject,a population, a venue, an event, or a situation in advance of need forthe medical items. In further embodiments, the inventory of medicalitems is risk profiled by determining a statistical level of likelihoodthat the items will be needed within 2 years, within 1 year, within 6months, within 1 month, within 2 weeks, within 1 week, or within 1 day.In further embodiments, risk profiling analysis comprises performingstatistical analysis, performing probability calculations, makingrecommendations, and making outcome predictions to predict a health oreconomic outcome of a patient or therapy, wherein said prediction isreal-time, individualized, and probabilistic-based and uses historic,peer-reviewed health or economic data and emerging health or economicdata. In some embodiments, the inventory of medical items comprisesitems that require a prescription from a licensed healthcare provider.In further embodiments, the inventory of medical items comprises: one ormore medications, one or more therapeutic devices, one or morediagnostic devices, or one or more diagnostic kits. In some embodiments,the device further comprises a software module for providinginstantaneous encounter-specific financial insurance coverage, whereinsaid insurance includes a level of guarantee and an associated premium.In further embodiments, the device further comprises a software modulefor processing payment.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a non-limiting example of an overall process flow forproviding remote diagnosis and therapy to a subject; in this case, aprocess flow including interaction between a patient and a telemedicalcare provider, collection of patient biometric data, and remotedispensing of a short-term supply of a prescribed medication authorizedby a pharmacist, followed by issuance of a long-term prescription andsubsequent billing.

FIG. 2 shows a non-limiting example of a process flow for providingremote pharmacy services; in this case, a process includingidentification of a subject and review of their electronic healthrecords, tele-video between a subject and a live, licensed healthcareprovider, and subsequent authorization by the provider of dispensing amedical item.

FIG. 3 shows a non-limiting example of a device for providing remotemedical therapy to a subject in a healthcare encounter; in this case, adevice including two USB connectors and visual and/or audio confirmationcomponents or a combination thereof.

FIG. 4 shows a non-limiting example of a system for providing remotemedical therapy to a subject in a healthcare encounter; in this case, atechnology device connected to an apparatus for dispensing medicamentsvia a USB connector device.

FIG. 5 shows a non-limiting example of a system for providing remotemedical therapy to a subject in a healthcare encounter; in this case, atechnology device connected to an apparatus for dispensing medicamentsvia a wireless interface.

FIG. 6 shows a non-limiting example of a device for providing remotemedical therapy to a subject in a healthcare encounter; in this case, adevice including a magnetic stripe reader and a variety of communicationinterfaces.

FIG. 7 shows a non-limiting, exemplary view of an apparatus fordispensing medical items; in this case, an apparatus including acommunications connector, a magnetic stripe, and a protective opaquesleeve.

FIG. 8 shows another non-limiting, exemplary view of an apparatus fordispensing medical items; in this case, an apparatus containing multipleunits of a medicament and including a lid with a closure mechanism in aclosed position, a communications connector, a magnetic stripe.

FIG. 9 shows another non-limiting, exemplary view of an apparatus fordispensing medical items; in this case, an apparatus containing multipleunits of a medicament and including a lid with a closure mechanism in anopen position, a communications connector, a magnetic stripe.

FIG. 10 shows a non-limiting example of a system for providing remotemedical therapy to a subject in a healthcare encounter; in this case, asystem including technology device, a connector device with a magneticstripe reader, and an apparatus for dispensing medical items.

FIG. 11 shows a non-limiting example of a system for providing remotemedical therapy to a subject in a healthcare encounter; in this case, asystem including a connector device with a USB interface and anapparatus for dispensing medical items.

FIG. 12 shows a non-limiting example of a system for providing remotemedical therapy to a subject in a healthcare encounter; in this case, anapparatus for dispensing medicaments integrated with a connector devicefor providing communication with a technology device.

DETAILED DESCRIPTION OF THE INVENTION

Described herein, in certain embodiments, are devices for providingremote medical therapy to a subject in a healthcare encounter, thedevice comprising a processor and a memory device, the device furthercomprising: a housing; at least one means for communicating with anapparatus for dispensing one or more medical items from an inventory ofmedical items, the inventory of medical items risk profiled to asubject, a population, a venue, an event, or a situation; at least onemeans for communicating with a technology device; and a software moduleenabling communications between the apparatus for dispensing one or moremedical items from an inventory of medical items and the technologydevice.

Also described herein, in certain embodiments, are systems for providingremote medical therapy to a subject in a healthcare encounter, thesystems comprising: an apparatus for dispensing one or more medicalitems from an inventory of medical items, the inventory of medical itemsrisk profiled to a subject, a population, a venue, or a situation; and aconnector device comprising: a processor; a memory; at least one meansfor communicating with the apparatus for dispensing one or more medicalitems from an inventory of medical items; at least one means forcommunicating with a technology device; and a software module enablingcommunications between the apparatus for dispensing one or more medicalitems from an inventory of medical items and the technology device.

Also described herein, in certain embodiments, are devices for providingremote medical therapy to a subject in a healthcare encounter, thedevice comprising a processor and a memory device, the device furthercomprising: a housing; a communications connection for communicatingwith an apparatus for dispensing one or more medical items from aninventory of medical items, the inventory of medical items risk profiledto a subject, a population, a venue, an event, or a situation; acommunications connection for communicating with a technology device,the technology device comprising a software module for remote monitoringor operation of the device by a telemedical care provider; a softwaremodule enabling communications between a connected apparatus fordispensing one or more medical items from an inventory of medical itemsand a connected technology device; and a confirmation component, theconfirmation component indicating if the correct apparatus fordispensing one or more medical items is in communication with thedevice.

CERTAIN DEFINITIONS

Unless otherwise defined, all technical terms used herein have the samemeaning as commonly understood by one of ordinary skill in the art towhich this invention belongs. As used in this specification and theappended claims, the singular forms “a,” “an,” and “the” include pluralreferences unless the context clearly dictates otherwise. Any referenceto “or” herein is intended to encompass “and/or” unless otherwisestated.

In some embodiments, as used herein, “subject” refers to a human beingrequesting or in need of healthcare, healthcare-related goods and/orservices or health related insurance or financial products and/orservices. In some cases, a subject is a patient. In further cases, asubject interacts with the devices and systems described herein. Inother cases, a subject is represented, for example, by a friend,relative, caregiver, healthcare provider, first responder, etc. and therepresentative interacts with the systems and devices described herein.In other embodiments, as used herein, “subject” refers to a non-humananimal in need of healthcare. In further cases, a subject is aveterinary patient and an owner, rescuer, or veterinary healthcareprovider interacts with the systems and devices described herein.

In some embodiments, as used herein, “onsite patient caregiver” refersto a person who has an interest in, or responsibility for, the healthand welfare of a patient and is present with the patient at least once,intermittently, often, or full-time. Non-limiting examples of onsitepatient caregivers include employees of a patient, members of apatient's family, hospice workers, and emergency medical technicians,paramedics, police officers, and firefighters.

In some embodiments, as used herein, “outpatient” refers to a subject ora situation not requiring or warranting overnight hospitalization.

In some embodiments, as used herein, “acute care” refers to short-termtreatment for an urgent medical condition such as a severe injury orepisode of illness.

In some embodiments, as used herein, “urgent care” refers to delivery ofoutpatient care outside of a hospital emergency department, usually onan unscheduled, walk-in basis.

In some embodiments, as used herein, “telemedicology” refers to a branchof medicine or surgery requiring specialized, formal, peer-reviewedtraining as a specialty or subspecialty of medicine concerned withsafely and efficaciously providing remote diagnosis and therapy viatelemedicine technology and equipment.

In some embodiments, as used herein, “telemedicologist” refers to aphysician, surgeon, dentist, and/or veterinarian, specialized intelemedicology and providing remote diagnosis and therapy viatelemedicine technology and equipment.

In some embodiments, as used herein, “telemedical care provider” or“TCP” refers to a healthcare worker trained and engaged in provision ofremote diagnosis and therapy via telemedicine technology and equipment.The term, as used herein, includes telemedicologists as well as licensedphysician extenders directly supervised by or reporting to atelemedicologist in activity related to the provision of remotediagnosis and therapy via telemedicine technology and equipment. In somecases, physician extenders directly supervised by or reporting to atelemedicologist include, nurse practitioners, physician assistants,registered nurses, licensed vocational nurses, emergency medicaltechnicians, and the like.

In some embodiments, as used herein, “telemedicalist” refers to aphysician specialized in the delivery of telemedical care to acutely illhospitalized subjects.

In some embodiments, as used herein, “health program” refers to anylegal, organizational, or financial arrangement for providing healthcareservices and/or healthcare administration to subjects. In variousembodiments, a health program includes, by way of non-limiting examples,a healthcare maintenance membership program, a HMO, a PPO, an IPA, apre-paid health program, a retainer-based health program, a conciergehealth program, a health insurance plan or policy, and the like.

Systems for Providing Remote Medical Therapy

In some embodiments, the devices and software applications disclosedherein are integrated into systems for providing remote medicaldiagnosis and therapy to a subject. In some embodiments, also disclosedare methods of using the devices, software applications, and systems forproviding remote medical diagnosis and therapy to a subject. In variousembodiments, the systems, devices, software applications, and methodsdisclosed herein are useful for providing remote medical diagnosis andtherapy to a subject in a wide range of healthcare encounters. Infurther embodiments, the systems, devices, software applications, andmethods disclosed herein are useful for providing remote medicaldiagnosis and therapy to a subject in convenient, semi-urgent, urgent,and/or emergent healthcare encounters. In various embodiments, thesystems, devices, software applications, and methods disclosed hereinare useful for providing remote medical diagnosis and therapy to asubject with acute, subacute, and/or chronic illnesses.

In some embodiments, the systems for providing remote medical diagnosisand therapy to a subject include a live, licensed healthcare provider,such as a telemedical care provider, located remotely from the subject.

In some embodiments, the systems for providing remote medical diagnosisand therapy to a subject include a networked device that includes atleast one processor, at least one memory device, and an operating systemconfigured to perform executable instructions. In some embodiments, thenetworked device is accessible to a subject. In further embodiments, thenetworked device includes hardware and software to facilitatetelecommunications between the subject (and/or a caregiver) and a live,licensed healthcare provider located remotely from the subject. In stillfurther embodiments, the system includes a medical therapy device withat least one USB connector and a confirmation component in communicationwith the networked device. In still further embodiments, the networkeddevice and/or medical therapy device includes one or more biosensors. Instill further embodiments, the networked device and/or medical therapydevice includes an apparatus for dispensing one or more medical itemsfrom an inventory of medical items to a subject.

In some embodiments, the systems for providing remote medical diagnosisand therapy to a subject include a computer program including executableinstructions operable to create an application. In various embodiments,the application includes one or more web applications, mobileapplications, and/or compiled applications. In some embodiments, one ormore computer programs are provided to the networked device. In someembodiments, one or more computer programs are provided to one or moreremote computer systems, servers, and/or databases. In furtherembodiments, one or more computer programs are provided via a computernetwork. In various embodiments, the computer programs include one ormore software modules. In some embodiments, a computer program includesa module for telecommunications between the networked device, or a userthereof, and a live, licensed healthcare provider. In some embodiments,a computer program includes a module for applying a diagnostic ortherapeutic analysis. In various embodiments, the module for applying adiagnostic or therapeutic analysis predicts a health or economicoutcome, predicts acute risks of a medical condition, with and withoutone or more potential therapies over various time periods. In someembodiments, a computer program includes a module for identifyingsubjects. In some embodiments, a computer program includes a module foridentifying and/or verifying the credentials of healthcare providers. Insome embodiments, a computer program includes a module for providinginstantaneous encounter-specific financial insurance coverage. Infurther embodiments, the insurance coverage includes a level ofguarantee and an associated premium.

In some embodiments, the systems, devices, and computer programsdisclosed herein are monitored or supervised, to some extent, by ahealthcare provider in real time. In further embodiments, the systems,devices, and software programs disclosed herein are operated by ahealthcare provider in real time. In some embodiments, the systems,devices, and computer programs disclosed herein optionally operate in anunsupervised, or automated, mode. For example, in some embodiments, thesystems, devices, and computer programs disclosed herein include anautomated emergency mode. In further embodiments, an automated emergencymode is activated by subjective observations by a live, remotehealthcare provider (e.g., choking, chest pain, etc.) or by objectivemeasurements of a biosensor (e.g., blood O₂ saturation of less than88%). In still further embodiments, in an automated emergency mode, thesystems, devices, and computer programs take autonomous actions,unsupervised by a live healthcare provider, including calling 911 orotherwise activating the emergency response system.

Many system configurations are contemplated herein and are suitable. Insome embodiments, the system includes a networked device and/or amedical therapy device that is present with, or is accessible by, asubject. In further embodiments, the subject directly accesses thetelecommunications features, biosensor features, medication dispensingfeatures, and/or diagnostic or therapeutic analysis features of thesystem.

In other embodiments, the system includes a plurality of medicaldiagnostic devices. In further embodiments, the features of the systemdescribed herein are distributed among a plurality of devices in anysuitable combination. For example, in some embodiments, atelecommunications module is housed in a separate device. By way offurther example, in some embodiments, a medical therapy device is housedin a separate device. By way of further example, in some embodiments, abiosensor module is housed in a separate device. By way of furtherexample, in some embodiments, a medication dispensing module is housedin a separate device. By way of further example, in some embodiments, adiagnostic or therapeutic analysis module is housed in a separatedevice. In other embodiments, the system includes one or more medicaltherapy devices with a reversibly separable, mobile component, which ispresent with, or is accessible by, a subject. In further embodiments,one or more of the telecommunications features, biosensor features,medication dispensing features in communications with a medical therapydevice, and/or diagnostic or therapeutic analysis features of the deviceare included with a reversibly separable, mobile element.

In some cases, the biosensor or biosensors are present with, or isaccessible by, the subject. In other cases, the biosensor or biosensorsare in a different location from the subject in need of examination(such as a centralized, stationary installation) and the subject travelsto this location for examination or to provide a fluid or tissue sample.In some cases, the apparatus, in communications with the medical therapydevice, for dispensing medical items is present with, or is accessibleby, the subject such that medical items are optionally dispenseddirectly to a subject or an appropriate caregiver. In other cases, theapparatus, in communications with the medical therapy device, fordispensing medical items is in a different location from the subject forwhom items are intended (such as a centralized, stationary installation)and the items are dispensed remotely for the subject.

In some embodiments, the devices, systems, and software areintranet-based. In some embodiments, the devices, systems, and softwareare Internet-based. In further embodiments, the devices, systems, andsoftware are World Wide Web-based. In still further embodiments, thedevices, systems, and software are cloud computing-based. In otherembodiments, the devices, systems, and software are based on datastorage devices including, by way of non-limiting examples, CD-ROMs,DVDs, flash memory devices, RAM (e.g., DRAM, SRAM, etc.), ROM (e.g.,PROM, EPROM, EEPROM, etc.), magnetic tape drives, magnetic disk drives,optical disk drives, magneto-optical drives, solid-state drives, andcombinations thereof.

Referring to FIG. 1, in a particular embodiment, a remote healthcaresystem described herein is utilized for risk profiling and dispensing amedication to a subject. In this embodiment, a patient initiates contactwith a remotely located telemedical care provider (including, forexample, a telemedicologist or telemedicalist) 1. The telemedical careprovider interviews the subject via a telecommunications ling todetermine if a medical emergency exists 2 and whether or not to activateEMS. The telemedical care provider subsequently utilizes remotebiosensors to collect biometric health data 3, which is integrated intoa personalized risk assessment for the subject in order to facilitatediagnosis and prescription of a medication. Further in this embodiment,the telemedical care provider transmits an authorization for ashort-term supply of a medication for the subject to a pharmacist 4. Thepharmacist in turn activates an apparatus for remotely dispensing themedication to the subject 5. The telemedical care provider follows-up byissuing a prescription for a long-term supply of medication 6, which isfilled by one of several traditional routes.

Referring to FIG. 2, in a particular embodiment, remote pharmacyservices are offered via presentation of a menu of pharmaceuticaloptions 20. A subject alternatively requests dispensing of a particularmedical item 21 or another request 22. Appropriateness of pharmaceuticalrequests requires query of an EHR database 23 and review of EHRs andsubject identification information 24. An audio-video conference 25between a subject and a remote healthcare provider (e.g., a pharmacist,etc.) further provides opportunity to assess the request and/or instructa subject on use of the pharmaceutical. Further in this embodiment, atelemedical care provider 26 optionally authorizes dispensing ofappropriate medical items from an apparatus for dispensing one or moremedical items from an inventory of items risk profiled to a particularsubject, family, population, venue, circumstance, or situation, which isin communication with the device and/or a networked device.

The inventions disclosed herein include business methods. In someembodiments, the devices, systems, software, and methods disclosedherein are marketed, advertised, and sold as, for example, products andservices for providing remote medical diagnosis and therapy to asubject. The products and services disclosed herein are particularlywell suited for providing low cost healthcare alternatives theuninsured, the underinsured, those in remote and rural areas, and thosein developing countries. The products and services disclosed herein arealso well suited for supplementation of existing healthcare systems inoutpatient, urgent care, or acute situations. The products and servicesdisclosed herein are also well suited for supplementation of existinghealthcare systems in emergency, disaster, or combat situations.

In some embodiments, the devices, systems, and software are employed, inpart or in whole, in healthcare facilities such as hospitals, hospice,nursing homes, urgent care offices, diagnostic laboratories, and thelike. In some embodiments, the devices, systems, and software areemployed, in part or in whole, in veterinary facilities such as animalhospitals, veterinary offices, and the like. In some embodiments, thedevices, systems, and software are employed, in part or in whole, in asubject's home. In some embodiments, the devices, systems, and softwareare employed, in part or in whole, in retail businesses such asboutiques, clinics, pharmacies, drug stores, or supermarkets. In someembodiments, the devices, systems, and software are mobile and employed,in part or in whole, in vehicles used by, for example, EMS personnel(e.g., EMTs, paramedics, etc.), police, fire fighters, first responders,FEMA personnel, military personnel, etc. In some embodiments, thedevices, systems, and software are mobile and elements are carried orworn by, for example, EMS personnel (e.g., EMTs, paramedics, etc.),police, fire fighters, first responders, FEMA personnel, militarypersonnel, and the like.

In some embodiments, the devices, software, systems, and methods arefurther utilized to provide remote telemedical services. These serviceswould, for example, improve the productivity of clinicians, relieveoverburdened healthcare systems, and create healthcare alternatives forthe uninsured, the underinsured, and those in remote areas anddeveloping countries with limited access to telemedical, outpatient,acute care, urgent care, and insurance services.

In some embodiments, the devices, software, systems, and methods arefurther utilized to provide remote medical risk assessment anddiagnostic services. These services would, for example, relieveoverburdened healthcare systems in outpatient, acute care, and urgentcare situations.

In some embodiments, the devices, software, systems, and methods arefurther utilized to provide remote insurance services providing, forexample, instantaneous encounter-specific coverage including a level ofguarantee and an associated premium.

In some embodiments, the devices, software, systems, and methods areutilized by contract research organizations (CROs), serviceorganizations that provide support to the pharmaceutical andbiotechnology industries in the form of research services outsourced ona contract basis. In further embodiments, the devices, software,systems, and methods are utilized to improve efficiency, reduce error,and improve the integrity of study data collected by a CRO. In furtherembodiments, the devices, software, systems, and methods are utilized bya CRO to facilitate the process of recruiting subjects for a researchstudy. For example, in many cases CROs search for a very specific cohortof individuals who meet the inclusion criteria for a particular study.Many of these individuals may be remotely located and coming into aresearch center for the study would create an imposition for both theCRO and the individual. In such embodiments, remote technology such asthat described herein improves the process for the CRO and theindividual.

In some embodiments, the devices, software, systems, and methods areutilized in transitional care. In many cases, inadequate carecoordination, including poor care transitions, result in wastefulspending and unnecessary hospital readmissions. When discharged from ahospital, patients often receive little information on how to care forthemselves, when to resume activities, what medication side effects tolook out for, and how to get answers to questions. Current and pendinglegislation creates powerful incentives for improving discharge methodsand improving the quality of transitional care. In further embodiments,the devices, software, systems, and methods are utilized to providefollow up consultations with patients to ensure they understandpost-care procedures, medication regimens, and for on-going analysis ofthe risk of readmission.

Subjects

In some embodiments, the systems, devices, software, and methodsdisclosed herein provide remote medical diagnosis and therapy to asubject. In further embodiments, a module for telecommunicationsprovides communications between one or more healthcare providers and asubject. In further embodiments, at least one remotely controlledbiosensor is used to examine a subject. In further embodiments, asoftware module applies a diagnostic or therapeutic analysis for asubject. In still further embodiments, diagnostic or therapeuticanalysis involves accessing health and economic records for a subject.In further embodiments, an apparatus dispenses one or more medical itemsto a subject. In further embodiments, a software module providesinstantaneous encounter-specific financial insurance coverage with alevel of guarantee and an associated premium to a subject.

In some embodiments, the subject is a human medical patient. In furtherembodiments, the subject is a human, pediatric medical patient. In otherembodiments, the subject is a human, adult or geriatric medical patient.In some embodiments, a human medical patient has one or more insurancepolicies for medical care.

In further embodiments, an insurance policy covers the events orconditions leading a subject to interact with the systems and devicesdescribed herein. In further embodiments, a human medical patient isunder the care of a physician. In some embodiments, a human medicalpatient does not have an insurance policy for medical care. In furtherembodiments, no insurance policy covers the events or conditions leadinga subject to interact with the systems and devices described herein. Infurther embodiments, a human medical patient is not under the care of aphysician.

In some embodiments, the subject is a non-human animal veterinarypatient. In further embodiments, a non-human animal subject is under thecare of an owner, caretaker, rescuer, or veterinarian. In still furtherembodiments, a non-human animal subject includes, by way of non-limitingexample, those attended to by exotic animal veterinarians, large animalveterinarians, domestic animal veterinarians, wildlife veterinarians,laboratory animal veterinarians, food animal veterinarians, and equineveterinarians. In still further embodiments, a non-human animal subjectincludes, by way of non-limiting example, those classified asinvertebrates, fish, amphibians, reptiles, birds, and mammals.

In some embodiments, the systems, devices, and software disclosed hereininclude hardware and software modules for identifying a subject and/ordetermining or verifying the insurance coverage of a subject. In furtherembodiments, a subject enters identifying information via an inputdevice (e.g., keyboard, keypad, touch screen, multi-touch screen,pointing device, microphone, video camera, etc.) associated with thesystems and devices disclosed herein. In further embodiments, a subjectpresents a physical object such as an insurance card, credit card,driver's license, etc. In still further embodiments, a subject presentstheir person as a source of identifying information. In someembodiments, a module for identifying a subject utilizes personalinformation including, by way of non-limiting example, name, address,employer, date of birth, age, and the like. In some embodiments, amodule for identifying a subject utilizes health insurance informationincluding, by way of non-limiting example, payer, primary carephysician, policy number, group number, name of insured, and the like.In some embodiments, a module for identifying a subject utilizes creditcard information including, by way of non-limiting example, card issuer,primary account holder, name on card, billing name, billing address,account number, and the like. In some embodiments, a module foridentifying a subject utilizes driver's license information including,by way of non-limiting example, name, license number, state of issuance,expiration date, and the like. In some embodiments, a module foridentifying a subject utilizes biometric information including, by wayof non-limiting example, retinal information, iris information,fingerprint information, palm print information, facial geometryinformation, voice information, and combinations thereof. In furtherembodiments, the module for identifying the subject utilizes at leastone remotely controlled biosensor to obtain biometric information.

Healthcare Providers

In some embodiments, the systems, devices, software, and methodsdescribed herein utilize the services of a healthcare provider. In someembodiments, a healthcare provider is live. As used herein, the term“live” describes a human healthcare provider, as opposed to anartificial intelligence or a software algorithm, who interacts with thesystems, devices, software, and/or subject described hereinasynchronously, substantially synchronously, or synchronously (e.g., inreal-time).

In some embodiments, a healthcare provider is remote. As used herein,the term “remote” describes a healthcare provider who is not presentwith a subject at the time healthcare services are rendered using theinventions described herein. In some embodiments, a remote healthcareprovider is outside of the facility, city, county, state, or country ofthe subject at the time healthcare services are rendered using theinventions described herein.

In some embodiments, a healthcare provider is an adjunct provider. Theterm “adjunct” describes a healthcare provider who is credentialed by alicensed primary healthcare provider facility, group, or individual toprovide remote care for one or more patients who are legally under thecare of the primary provider. In some embodiments, the adjuncthealthcare provider is a telemedical care provider.

In some embodiments, the methods, systems, and software described hereinutilize the services of one or more telemedical care providers. In someembodiments, telemedicology refers to a branch of medicine or surgeryrequiring specialized, formal, peer-reviewed training as a specialty orsubspecialty of medicine concerned with safely and efficaciouslyproviding remote diagnosis and therapy via telemedicine technology andequipment. In some embodiments, formal training in telemedicologyrequires completion of a fellowship in telemedicology. In furtherembodiments, a telemedicologist is a physician, surgeon, dentist and/orveterinarian specialized in telemedicology and providing remotediagnosis and therapy via telemedicine technology and equipment. Instill further embodiments, a telemedical care provider (TCP) is ahealthcare worker trained and engaged in provision of remote diagnosisand therapy via telemedicine technology and equipment. In someembodiments, a TCP is, for example, a telemedicologist. In furtherembodiments, a TCP is a telemedicologist (e.g., physician, surgeon,dentist, veterinarian, or other licensed professional) who, following aresidency and/or fellowship in their field, is board certified forexample by the American board of surgery, medicine, pediatrics inprimary care and or in a subspecialty such as cardiology, etc. In stillfurther embodiments, a TCP is a telemedicologist (e.g., physician,surgeon, dentist, veterinarian, or other licensed professional) who is acertified by a recognized body providing a peer reviewed telemedicologyeducation program. In some embodiments, a TCP is, for example, alicensed physician extender (e.g., nurse practitioner, physicianassistant, registered nurse, pharmacist, licensed vocational nurse,emergency medical technician, etc.) directly supervised by or reportingto a telemedicologist in activity related to the provision of remotediagnosis and therapy via telemedicine technology and equipment. In someembodiments, a telemedicalist is a physician specialized in the deliveryof telemedical care to acutely ill hospitalized subjects.

In some embodiments, a telemedical care provider is a doctorate levelhealth care provider. In further embodiments, a telemedical careprovider is a physician, dentist, or veterinarian telemedicologist. Inother embodiments, a telemedical care provider is a non-physician. Infurther embodiments, a telemedical care provider is, by way ofnon-limiting examples, a pharmacist, a dentist, a physician assistant, anurse practitioner, a registered nurse, a pharmacist, a chiropractor, anemergency medical technician, a licensed practical nurse, a certifiedultrasound technician, a psychologist, a social worker, a militarymedic, a physical therapist, an occupational therapist, a speechtherapist, a radiology technician, a cardiac catheterization technician,a clinical pathology laboratory technician, a medical aesthetician, alicensed medical technologist, a toxicologist consultant, a credentialedmedical legal consultant, and a credentialed hospital operationsadministrator. In some embodiments, a telemedical care provider is aveterinarian or a veterinary nurse, assistant, or technician.

In some embodiments, the systems, devices, software, and methodsdescribed herein utilize the services of a plurality of healthcareproviders. In further embodiments, a plurality of healthcare providersincludes 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19,20, 30, 40, 50, 60, 70, 80, 90, 100, 200, 300, 400, 500 or moreproviders, including increments therein. In some embodiments, thesystems, devices, software, and methods described herein utilize theservices of at least 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16,17, 18, 19, 20 or more healthcare providers. In further embodiments, aplurality of healthcare providers use the systems simultaneously. Instill further embodiments, a healthcare provider is identified orselected for a particular case or contact based on parameters including,by way of non-limiting examples, a patient's condition, disease, orinjury, severity of a patient's condition, disease, or injury, apatient's insurance eligibility, or availability.

In some embodiments, the systems, devices, software, and methodsdescribed herein include hardware and a software module to verify ahealthcare provider's identity. In further embodiments, a providerenters identifying information via an input device (e.g., keyboard,keypad, touch screen, multi-touch screen, pointing device, microphone,video camera, etc.) associated with the systems and devices disclosedherein. In further embodiments, a provider presents a physical objectsuch as a driver's license, credit card, professional association card,etc. In still further embodiments, a provider presents their person as asource of identifying information. In some embodiments, a module foridentifying a provider utilizes information including, by way ofnon-limiting example, personal information, medical license information,malpractice insurance information, credit card information, driver'slicense information, and biometric information. In some embodiments, thesystems, products, programs, and methods described herein includehardware and a software module to biometrically verify a provider'sidentity. In further embodiments, the biometric hardware and software isadapted to recognize physiological characteristics including, by way ofnon-limiting examples, retinal information, iris information,fingerprint information, palm print information, facial geometryinformation, voice information, and combinations thereof.

In some embodiments, a healthcare provider operates one or more of themedical therapy devices, apparatus, and/or software modules of thesystems and devices described herein. In further embodiments, ahealthcare provider operates, by way of non-limiting examples, abiosensor, an apparatus for dispensing one or more medical items,hardware and software for telecommunications, software for applying adiagnostic or therapeutic analysis, software for providing access to oneor more electronic health records for a subject, software foridentifying a subject, and software for providing instantaneousencounter-specific financial insurance coverage. In other embodiments, ahealthcare provider assists in the operation of one or more of themedical therapy devices and/or software modules described herein. In yetother embodiments, a healthcare provider supervises or overseesoperation of one or more of the medical therapy devices and/or softwaremodules described herein.

In some embodiments, the systems, devices, software, and methodsdescribed herein do not utilize the services of a live healthcareprovider. For example, in some embodiments, the systems and devicesdescribed herein include a non-communication mode, described furtherherein. In further embodiments, the systems and devices described hereinoperate in a non-communication mode when communication protocols fail,when communication channels or signals fail or are lost, or when devicesare placed in a location where one or more communication protocols,channels, or signals are unavailable. In a non-communication mode, alive, remote healthcare provider is unable to monitor, supervise, oroperate components of a device. By way of further example, in someembodiments, the systems and devices described herein include anemergency mode, described further herein. In an emergency mode, in someembodiments, components of a system or device act autonomously, withoutmonitoring, supervision, or operation by a live, remote healthcareprovider.

Credentialing

In some embodiments, a live healthcare provider is licensed, forexample, by one or more U.S. state medical boards, a branch of the U.S.Federal Government (e.g., the Veteran's Administration, Department ofHealth and Human Services, and the Department of Defense, etc.) or aforeign national government. In some embodiments, a live healthcareprovider is insured for professional malpractice.

In some embodiments, a subject is under the care of a primary careprovider. In further embodiments, an adjunct healthcare provider iscredentialed by a subject's primary care provider. In still furtherembodiments, an adjunct healthcare provider is credentialed by asubject's primary care provider to provide, for example, remotediagnosis and therapy, telemedical services, urgent care services,outpatient services, acute care services, pharmacy services, orinsurance services to the subject. In still further embodiments, theadjunct healthcare provider is identified or selected based on one ormore of: type of patient's condition, severity of a patient's condition,a patient's insurance eligibility, or availability of one or moreadjunct healthcare providers. In still further embodiments, a subject'sprimary care provider credentials more than one adjunct healthcareprovider for a particular subject.

In other embodiments, a subject is under the care of a live healthcareprovider described herein. In further embodiments, a live healthcareprovider provides, for example, remote diagnosis and therapy,telemedical services, urgent care services, outpatient services, acutecare services, pharmacy services, or insurance services to a subject. Inappropriate circumstances, a live healthcare provider refers a subjectto another healthcare provider. In appropriate circumstances, a livehealthcare provider triages a subject to a higher level of care (e.g.,inpatient care, emergency response system, etc.). In appropriatecircumstances, a live healthcare provider triages a subject to a lowerlevel of care (e.g., self-care, bed rest, oral hydration, etc.).

The systems, devices, software, and methods described herein include, invarious embodiments, a software module for verifying the identity and/orcredentials of a healthcare provider. In some embodiments, the softwaremodule creates, stores, and retrieves healthcare provider identity andcredential records. In some embodiments, the software module verifies acredential issued by a licensed primary healthcare provider facility,group, or individual. In further embodiments, the primary healthcareprovider facility, group, or individual is licensed, for example, by oneor more U.S. state medical boards, a branch of the U.S. FederalGovernment (e.g., the Veteran's Administration, Department of Health andHuman Services, and the Department of Defense, etc.) or a foreignnational government. In further embodiments, a credential issued for alive, remote, adjunct healthcare provider to provide remote adjunct carefor one or more patients legally under the care of said licensed primaryhealthcare provider facility, group, or individual. In some embodiments,a patient is admitted to the healthcare facility. In other embodiments,a patient is not admitted to the healthcare facility. In furtherembodiments, a patient is receiving care as an outpatient or emergencydepartment patient at the healthcare facility.

In some embodiments, the software module verifies a credential issued bya licensed primary healthcare provider facility, group, or individualthat indicates the remote adjunct healthcare provider successfullycompleted a medical and legal screening process. In further embodiments,a screening process includes verification of, by way of non-limitingexamples, prescription license, education, training, certifications,professional references, malpractice insurance coverage, malpracticeinsurance state, malpractice insurance coverage limits, legal license topractice their profession, and state of licensure. In still furtherembodiments, a screening process includes one or more live interviews ofa remote adjunct healthcare provider by a licensed primary healthcareprovider facility, group, or individual.

In some embodiments, the software module verifies a credential thatindicates a licensed primary healthcare provider facility, group, orindividual has granted admitting privileges to a remote adjuncthealthcare provider. In further embodiments, admitting privilegesinclude billing privileges. In some embodiments, admitting privilegesinclude the right to admit patients to a facility for a specificdiagnostic or therapeutic service. In some embodiments, admittingprivileges include the right to admit patients to a facility for aconsultative service. In some embodiments, admitting privileges aregranted to a non-physician to treat patients independently with theappropriate state's required oversight and review of the healthcareprotocols used by a legally licensed, credentialed physician to empowerthe non-physician to execute healthcare.

Biosensors

In some embodiments, the systems for providing remote therapy to asubject includes a networked device including a processor, a memory, andan operating system configured to perform executable instructions and amedical therapy device in communications with an apparatus fordispensing one or more medical items from an inventory of medical itemsto a subject. In further embodiments, the networked medical therapydevice includes one or more biosensors.

Any suitable biosensor is used with the systems, devices, software, andmethods disclosed herein.

In some embodiments, a biosensor is a physicomechanical sensor. Infurther embodiments, a biosensor includes, by way of non-limitingexamples, a thermometer, a scale, a blood pressure sensor, and arespirometer.

In some embodiments, a biosensor is a physicochemical sensor. In furtherembodiments, a biosensor includes physicochemical sensors for culturingand/or analyzing a tissue sample or a fluid sample such as blood,saliva, urine, mucus, hair, etc. In further embodiments, analysisincludes qualitative analysis, such as detecting a property, detecting asubstance, detecting a reaction, or detecting a pathogen. In furtherembodiments, analysis includes quantitative analysis, such as measuringa property, measuring a substance, measuring a reaction, or measuring apathogen. In still further embodiments, a biosensor includes, by way ofnon-limiting examples, blood chemistry devices, urinalysis devices,blood glucose sensors, pulse oximeters, and the like.

In some embodiments, a biosensor is an imaging sensor. In furtherembodiments, an imaging sensor includes, by way of non-limitingexamples, a video camera, a high definition video camera, a thermalimaging camera, a thermography device, magnetic resonance imaging (MRI)device, an ultrasound device (e.g., echocardiography, obstetricalsonography, intravascular ultrasound, etc.), and a tomography device(e.g., computed tomography (CT), computed axial tomography (CAT), etc.).

In some embodiments, a biosensor is an acoustic sensor. In furtherembodiments, a biosensor includes, by way of non-limiting examples, astethoscope and specialized remote auscultation devices adapted forhearing gut sounds, heart sounds, or lung/breath sounds.

In some embodiments, a biosensor is a bioelectric sensor. In furtherembodiments, a biosensor includes, by way of non-limiting examples, anelectrocardiography (ECG or EKG) device, a heart rate monitor, anelectromyography (EMG) device, an impedance sensor, and a galvanic skinresponse sensor.

The networked medical devices described herein optionally utilizebiosensors to perform a wide range of suitable diagnostic tests. Invarious embodiments, suitable diagnostic tests include, by way ofnon-limiting examples, blood sugar test (e.g., diabetes), complete bloodcount or CBC blood test (e.g., anemia, infection, etc.), troponin bloodtest (e.g., myocardial infarction), serum creatinine blood test (e.g.,kidney function), Chem 7 blood test (e.g., nutritional status,electrolytes imbalances, etc.), ultrasound and fiber optic cameraexamination, spirometer test (e.g., asthma, COPD, etc.), INR blood test(e.g., Coumadin patient), urine test detecting blood (e.g., gross andmicroscopic hematuria), blood cholesterol test (e.g., hyperlipidemia),blood pressure test (intermittent vs. continuous) (e.g., hypertension orhypotension), pulse oximetry test (e.g., hypoxia, etc.), and temperaturemeasurement (e.g., fever, etc.), and 12 lead EKG (e.g., myocardialinfarction, arrhythmias, etc.).

Many modes of operation are suitable for biosensors used with thesystems, devices, software, and methods disclosed herein.

In some embodiments, a biosensor operates in an automated mode. Infurther embodiments, an automated biosensor operates according to apre-planned script or set of instructions without direction from ahealthcare provider, an operator, or a subject. For example, a digitalscale automatically weights a subject without instruction and recordstheir weight.

In some embodiments, a biosensor operates in a subject-operated mode. Infurther embodiments, a subject directs or controls a biosensor. Forexample, a subject places a wired electronic thermometer under theirtongue and activates a control to begin a body temperature reading. Insome embodiments, a subject operates a biosensor under instructionprovided by a live, remote healthcare provider or a softwareapplication.

In some embodiments, a biosensor operates in a remotely controlled mode.In further embodiments, a healthcare provider directs or controls abiosensor from a remote location. For example, a live healthcareprovider uses a software application to remotely manipulate and positionan autofocus, high definition video camera that is mounted on a roboticarm to examine a skin lesion on a subject's face. By way of furtherexample, a live healthcare provider uses a software application toremotely manipulate and position an ultrasound probe to examine asubject's heart.

In some embodiments, a biosensor operates in a subject-operated modeand/or a remotely controlled mode and is further observed, assisted, oroperated by technician. In further embodiments, a technician is presentwith the subject (e.g., onsite). For example, a live, remote healthcareprovider remotely supervises and operates an ECG device to interpret theelectrical activity of the heart of a subject. A technician present withthe subject assists in connecting the electrodes to appropriate sites onthe surface of the subject's skin.

In various embodiments, one or more biosensors are capable of operatingin multiple modes described herein. In further embodiments, such abiosensor switches between modes at predetermined points in a procedure.In further embodiments, such a biosensor switches between modes uponrequest of a healthcare provider, an onsite technician a subject, or anappropriate caregiver. For example, a subject can position an ultrasoundprobe under the direction of a healthcare provider and then activate acontrol that shifts control of the probe to a live, remote healthcareprovider to fine tune the positioning via remote robotic controls.

In some embodiments, a biosensor is permanently attached to a device orsystem described herein. In other embodiments, a biosensor is reversiblyattached to a device or system described herein and communicates withthe device or system via wireless protocols including, by way ofnon-limiting embodiments, infrared, Bluetooth, ZigBee, Wi-Fi, 3G/4G/LTEwireless protocols and NFC protocols. In other embodiments, a biosensoris reversibly attached to a device or system described herein. Infurther embodiments, a removable biosensor stores data in memory and thedata is communicated to the device or system at a later time when thebiosensor is reconnected to the device or system.

In some embodiments, the systems and devices described herein do notinclude permanent biosensors. In further embodiments, remote diagnosisand therapy is provided by way of, for example, the experience of one ormore live healthcare providers, data contained in electronic records anddatabases (e.g., EHRs, medical literature, news, etc.), datacommunicated and input by a subject or an appropriate caregiver,software for predicting acute risks and health and/or economic outcomesof patients, potential therapies, and the like, including combinationsthereof.

Telecommunications

In some embodiments, the systems, devices, software, and methodsdescribed herein include hardware and software elements forestablishing, conducting, and maintaining telecommunications. In furtherembodiments, telecommunications are used by the devices and systemsdescribed herein, for example, to communicate with subjects, healthcareproviders, and other users of the devices and systems via a networkeddevice; to access electronic health records and other sources ofinformation; to monitor, regulate, control, and exchange data withbiosensors; to monitor, regulate, control, and exchange data with anapparatus for dispensing medical items; to monitor, regulate, control,and exchange data with a module for applying a diagnostic or therapeuticanalysis; and to monitor, regulate, control, and exchange data with amodule for providing instantaneous encounter-specific financialinsurance coverage that includes a level of guarantee and an associatedpremium.

In some embodiments, a module for telecommunications creates acommunications link. In further embodiments, communication links enableone-way, two-way, or multi-way communication. In various furtherembodiments, communication links enable communication via, by way ofnon-limiting examples, telephone, push-to-talk, audio conference, videoconference, SMS, MMS, instant message, Internet bulletin board, blog,microblog, fax, Internet fax, electronic mail, VoIP, or combinationsthereof. In some embodiments, one or more communications links areinteractive and provide real-time (e.g., synchronous) or near real-time(e.g., asynchronous) two-way communication or transfer of data and/orinformation.

In some embodiments, a module for telecommunications creates multiplecommunications links. In various embodiments, a module fortelecommunications creates 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40,50, 60, 70, 80, 90, 100 or more communications links, includingincrements therein. In further embodiments, multiple communicationslinks are created and maintained serially, or one at a time. In otherembodiments, multiple communications links are created and maintained inparallel, or simultaneously.

In some embodiments, the communications link enables a live, remotehealthcare provider to communicate with one or more other parties andvice versa. In some embodiments, the communications link is between alive, remote healthcare provider and a subject or a group of subjects.In some embodiments, the communications link is between a live, remotehealthcare provider and an onsite caregiver or group of caregivers. Infurther embodiments, an onsite caregiver is a person who has an interestin, or responsibility for, the health and welfare of a subject and ispresent with the subject at least once, intermittently, often, orfull-time. Non-limiting examples of onsite caregivers include anemployee of a subject, a member of a subject's family, a physician, adentist, a physician assistant, a nurse practitioner, a registerednurse, a pharmacist, a chiropractor, a licensed practical nurse, aveterinarian, a veterinary technician, a certified ultrasoundtechnician, radiology technician, a psychologist, a social worker, aphysical therapist, an occupational therapist, a speech therapist, acardiac catheterization technician, a clinical pathology laboratorytechnician, a medical aesthetician, a licensed medical technologist, ahospice worker, an emergency medical technician, a paramedic, a policeofficer, and a firefighter. In further embodiments, an onsite caregivercommunicates with a live, remote healthcare provider on behalf of asubject or to describe the condition of the subject. In someembodiments, the communications link is between a live, remotehealthcare provider and one or more medical product or service providersincluding, by way of non-limiting examples, pharmaceutical productproviders, diagnostic service providers, and therapeutic serviceproviders. In further embodiments, a live, remote healthcare providercommunicates with one or more medical product or service providersregarding products or services that are prescribed or recommended for apatient or the costs associated with such products or services. In someembodiments, the communications link is between a live, remotehealthcare provider and one or more consultants including, by way ofnon-limiting examples, medical consultants, legal consultants, insuranceconsultants, and financial consultants. In further embodiments, a live,remote healthcare provider communicates with one or more medicalconsultants regarding a subject's medical history, diagnosis, past,current, or contemplated therapies, or prognosis. In furtherembodiments, a live, remote healthcare provider communicates with one ormore legal consultants regarding compliance with applicable laws,regulations, and rules. In further embodiments, a live, remotehealthcare provider communicates with one or more insurance andfinancial consultants regarding a subject's eligibility, coverage,benefits, deductable, or payment status. In still further embodiments,multiple communications links are established with a plurality ofproviders and/or consultants to form a conference to remotely discussthe care of one or more subjects.

In various embodiments, the module for telecommunications utilizes manysuitable communications channels. In some embodiments, the module fortelecommunications utilizes wired or fiber optic telephone, wired orfiber optic Internet, Wi-Fi, and the like, including combinationsthereof. In various embodiments, the module for telecommunicationsutilizes a wide array of suitable communications protocols. In someembodiments, the module for telecommunications utilizes wiredcommunications protocols. In some embodiments, the module fortelecommunications utilizes wireless communications protocols. Infurther embodiments, suitable communications protocols include, by wayof non-limiting examples, 3G (3rd generation mobile telecommunications),4G (4th generation mobile telecommunications), and geosynchronous andlow Earth orbit (LEO) satellite, or combinations thereof. In furtherembodiments, suitable communications protocols include, by way ofnon-limiting examples, transmission control protocol/internet protocol(TCP/IP), hypertext transfer protocol (HTTP), hypertext transferprotocol secure (HTTPS), file transfer protocol (FTP), user datagramprotocol (UDP), internet message access protocol (IMAP), post officeprotocol (POP), simple mail transfer protocol (SMTP), and simple networkmanagement protocol (SNMP), or combinations thereof. In furtherembodiments, suitable communications protocols include, by way ofnon-limiting examples, voice over Internet protocol (VoIP) and voice, orcombinations thereof.

In some embodiments, the module for telecommunications includes hardwareand software to allow communication via multiple, redundantcommunications protocols. In further embodiments, the module switchesbetween protocols based on user preference, protocol availability,signal strength, and the like. In some embodiments, the systems anddevices described herein include a non-communication mode, wherein amodule for telecommunications does not operate. In further embodiments,the systems and devices described herein operate in a non-communicationmode when communication protocols fail or when communication channels orsignals fail or are lost. In still further embodiments, the systems anddevices described herein operate in a non-communication mode when placedin a location where one or more communication protocols, channels, orsignals are unavailable.

In some embodiments, the systems and devices described herein do notinclude telecommunications elements. In further embodiments, remotediagnosis and therapy is provided by way of, for example, the experienceof one or more live healthcare providers, data stored locally, datacommunicated and input by a subject or an appropriate caregiver, datacaptured by biosensors, software for predicting acute risks and healthand/or economic outcomes of a patients and potential therapies, and thelike, including combinations thereof.

In some embodiments, the module for telecommunications provides agraphic representation of the subject and the live healthcare provider.In some embodiments, a graphic representation is two-dimensional. Inother embodiments, a graphic representation is three-dimensional. Insome embodiments, a three-dimensional graphic representation is avirtual reality environment. In some embodiments, the subject and thelive healthcare provider are depicted similarly to their actualappearance. In further embodiments, the actual appearance of ahealthcare provider is determined based on historic records such aspersonnel files or based real-time information captured by a digitalcamera, video camera, and/or microphone. In further embodiments, theactual appearance of a subject is determined based on historic recordssuch as medical records or based real-time information captured by adigital camera, video camera, and/or microphone. In other embodiments,the subject and the live healthcare provider are depicted differentlyfrom their actual appearance. In further embodiments, a subject or ahealthcare provider selects an appearance for the graphicrepresentation. In some embodiments, a graphic representation depictsthe subject and the live healthcare provider in a virtual medicalsetting. In further embodiments, a virtual medical setting is, by way ofnon-limiting example, a medical office, an examination room, adiagnostic facility, a medical laboratory, an ultrasound station, aclassroom, and the like.

In some embodiments, the systems, devices, software, and methodsdescribed herein further comprise a software module for electronicallyrecording communications conducted over one or more communicationslinks. In further embodiments, the audio, video, health record data,financial record data, and insurance record data exchanged are recorded.In still further embodiments, recorded communications are used to ensuresound medical policies and procedures and compliance with applicablelaws, regulations, and rules.

In some embodiments, the communication links meet applicable legal datasecurity standards. In some embodiments, the communication links meetapplicable legal patient privacy standards. In further embodiments, theapplicable legal standards include, by way of non-limiting examples, theHealth Insurance Portability and Accountability Act of 1996 and TheHealth Information Technology for Economic and Clinical Health Act of2009. In some embodiments, live and/or recorded electroniccommunications are encrypted. In further embodiments, cryptographicprotocols such as Secure Sockets Layer (SSL) or Transport Layer Security(TLS) are applied to Internet-based communications such as web traffic,electronic mail, Internet faxing, instant message, and VoIP.

Diagnostic or Therapeutic Analysis

In some embodiments, the systems, devices, software, and methodsdescribed herein include a software module for applying a diagnostic ortherapeutic analysis. In some embodiments, a software module forapplying a diagnostic or therapeutic analysis is used by a livehealthcare provider. In further embodiments, a software module forapplying a diagnostic or therapeutic analysis is supervised, monitored,or operated by any of the live healthcare providers described herein. Insome embodiments, the software module for applying a diagnostic ortherapeutic analysis supplements the professional judgment of a livehealthcare provider. In other embodiments, a software module forapplying a diagnostic or therapeutic analysis is configured to operatein an automated mode and does not require supervision, monitoring, oroperation by a healthcare provider.

Medical Items

In some embodiments, disclosed herein are systems and devices comprisingan apparatus for dispensing one or more medical items and methods ofusing the same. In some embodiments, the medical items are dispensed toa subject as described herein. In other embodiments, the medical itemsare dispensed to a caregiver, medical representative, guardian, or legalrepresentative of a subject.

In some embodiments, the apparatus for dispensing medical items is inthe same location as the subject for whom items are intended and theitems are dispensed directly to the subject or an appropriate caregiver.In other embodiments, the apparatus for dispensing medical items is in adifferent location from the subject for whom items are intended and theitems are dispensed remotely for the subject.

In some embodiments, the medical items are dispensed singly orindividually. In other embodiments, the medical items are dispensed inlimited numbers. In further embodiments, the medical items are dispensedloose, unpackaged, or in a temporary package such as a cup, tray, box,or envelope. In still other embodiments, the medical items are dispensedin bulk.

In some embodiments, the apparatus for dispensing one or more medicalitems includes an outer sleeve-like casing covering an inner drawer. Infurther embodiments, the sleeve-like casing includes an opening whereina tapered cantilever and traction pad mechanism provide childproofing.

In still further embodiments, the apparatus for dispensing one or moremedical items includes a unique identifier on a chip and a data port(e.g., mini-USB, micro-USB, Type A or B USB, etc.) forming a part of theinner drawer for confirmation and verification of the correct medicationwhen in communication with the medical therapy device. In still furtherembodiments, the apparatus for dispensing one or more medical itemsincludes an integrated memory chip for tracking and recording events.

In some embodiments, the medical items are pre-packaged. In furtherembodiments, pre-packaged medical items are sealed in a container (e.g.,a package, etc.) prior to introduction to the dispensing apparatus. Inother embodiments, pre-packaged medical items are sealed in a container(e.g., a package, etc.) prior to dispensing. In further embodiments, thecontainer has a sterile interior. In further embodiments, the containeris designed to prevent opening by a child (e.g., child-resistant,child-proof, etc.). Many containers are suitable for the medical itemsand include, by way of non-limiting examples, bottles, blisterpackaging, boxes, envelopes, and the like, each composed of one or moreof several suitable materials that include, for example, plastic, foil,paper, cardstock, cardboard, Mylar, and the like. In some embodiments alocking mechanism will be in place to prevent opening of the medicationcontainer until the identity of the medication is verified by thesoftware and device. These embodiments can include and are not limitedto a closed loop circuit that once opened, the circuit becomes open andalerts the software that the medication has been opened. Additionally, ashape memory alloy that can change configuration due to temperature,ninitol, would be employed to prevent opening until the use of thedevice causes a shift in temperature and allows the opening of thecontainer. Another embodiment would include a cantilever that ispositioned in front of the opening of the container that is mechanicallymoved when the device correctly identifies the medication. In stillfurther embodiments, the apparatus for dispensing medicaments itself iscontained within a tamper proof package. In some embodiments, acontainer (e.g., a package, etc.) includes printed text. In furtherembodiments, the text is printed directly on the container. In otherembodiments, the text is printed on a label that is applied to thecontainer. In various embodiments, the printed text indicates, by way ofnon-limiting examples, the nature of the medical item or items, theidentity of the items, the number of items, the use of the items,instructions for use, warnings, and the like. In various furtherembodiments, where the medical item is a prescription ornon-prescription pharmaceutical, the printed text indicates, by way ofnon-limiting examples, drug name, dosage, expiration date, lot number,and the like. In various further embodiments, the printed text iscustomized and indicates, by way of non-limiting examples, the name ofthe subject, the address of the subject, the name of the prescribingprofessional or entity, and the address of the prescribing professionalor entity, and the like. In some embodiments, the printed text issupplemented by graphics, photographs, or pictograms indicating thesame.

In some embodiments, the inventory of medical items is risk profiled toa particular subject, population, venue, situation, or a combinationthereof. In further embodiments, the inventory of medical items isdetermined by profiling health and/or economic risk for a subject or apopulation in advance of need for said medical items. In still furtherembodiments, software for applying a diagnostic or a therapeuticanalysis disclosed herein is utilized to predict health or economicoutcomes for a subject, a population, a venue, a situation, or acombination thereof in order to determine a risk profiled inventory ofmedical items. In some embodiments, the inventory of medical items isdetermined by performing a diagnostic or therapeutic analysis for asubject, a family, a population, a venue, a situation, or a combinationthereof. In further embodiments, the inventory of medical items isdetermined by performing statistical analysis, performing probabilitycalculations, making recommendations, and making outcome predictions topredict a health or economic outcome of a patient or therapy, whereinsaid prediction is real-time, individualized, and probabilistic-basedand uses historic, peer reviewed health or economic data and emerginghealth or economic data. In some embodiments, the inventory of medicalitems is determined by performing a diagnostic or therapeutic analysisfor a subject, a family, a population, a venue, a situation, or acombination thereof. In further embodiments, the inventory of medicalitems is determined by predicting acute risks, with and without one ormore potential therapies, based on the severity of a condition and risksassociated with each potential therapy to determine the intensity oftherapy recommended.

In certain embodiments where an inventory of medical items is riskprofiled to a particular subject, the inventory is determined bypredicting future health and/or economic risks to the subject. Infurther embodiments, the inventory comprises or is enriched with medicalitems selected for their potential utility to the subject. In stillfurther embodiments, the inventory comprises medical items not currentlyutilized by the subject. In some embodiments, the medical items arepre-prescribed to the subject as PRN (i.e., pro re nata, meaning “asneeded”) medications. In certain embodiments where an inventory ofmedical items is risk profiled to a particular family, the inventory isdetermined by predicting future health and/or economic risks to themembers of the family. In further embodiments, the inventory comprisesor is enriched with medical items selected for their potential utilityto the members of the family. In still further embodiments, theinventory comprises medical items not currently utilized by any memberof the family. In some embodiments, the medical items are pre-prescribedto the one or more members of the family as PRN (i.e., pro re nata,meaning “as needed”) medications. In certain embodiments where aninventory of medical items is risk profiled to a particular populationof subjects, the inventory is determined by predicting future healthand/or economic risks to the population of subjects. In furtherembodiments, the inventory comprises or is enriched with medical itemsselected for their potential utility to the population. In certainembodiments where an inventory of medical items is risk profiled to aparticular venue or location, the inventory is determined by predictingfuture health and/or economic risks to individuals present at the venueor location. In further embodiments, the inventory comprises or isenriched with medical items selected for their potential utility toindividuals present at the venue or location. In certain embodimentswhere an inventory of medical items is risk profiled to a particularsituation or circumstance, the inventory is determined by predictingfuture health and/or economic risks to individuals in the situation orcircumstance.

In some embodiments, the inventory of medical items is delivered beforeit is needed based on anticipated need. In further embodiments,anticipated need is based on statistical level of likelihood that theitems will be needed in the short-term future. In further variousembodiments, anticipated need is based on statistical level oflikelihood that the items will be needed within, by way of non-limitingexamples, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18,19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, or more days, includingincrements therein. In further various embodiments, anticipated need isbased on statistical level of likelihood that the items will be neededwithin, by way of non-limiting examples, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or more months,including increments therein. In some embodiments, ahead in timedelivery enables the systems, devices, and methods described herein toprovide real in time therapy.

Many types of medical items are suitable for dispensing to the subjectsdescribed herein. In various embodiments, the medical items include, byway of non-limiting examples, vitamins, minerals, dietary supplements,herbal remedies, over-the-counter medications, prescription medications,therapeutic devices, diagnostic devices, diagnostic kits, andeducational materials.

In some embodiments, medical items include one or more vitaminsupplement. In various further embodiments, suitable vitamin supplementsinclude vitamin A (e.g., retinol), vitamin B1 (e.g., thiamine), vitaminB12 (e.g., cyanocobalamin, hydroxycobalamin, and methylcobalamin),vitamin B2 (e.g., riboflavin), vitamin B3 (e.g., niacin andniacinamide), vitamin B5 (e.g., pantothenic acid), vitamin B6 (e.g.,pyridoxine, pyridoxamine, and pyridoxal), vitamin B7 (e.g., biotin),vitamin B9 (e.g., folic acid), vitamin C (e.g., ascorbic acid), vitaminD (e.g., cholecalciferol), vitamin E (e.g., tocopherols andtocotrienols), and vitamin K.

In some embodiments, medical items include one or more mineralsupplement. In various further embodiments, suitable mineral supplementsinclude, by way of non-limiting examples, calcium, chromium, iodine,iron, magnesium, phosphorus, potassium, selenium, and zinc.

In some embodiments, medical items include one or more dietarysupplement. In various further embodiments, suitable dietary supplementsinclude, by way of non-limiting examples, enzymes, herbs, and aminoacids.

In some embodiments, medical items include one or more herbal remedies.In various further embodiments, suitable herbal remedies include, by wayof non-limiting examples, Acai (Euterpe oleracea), Alfalfa (Medicagosativa), Aloe vera, Arnica (Arnica montana), Asthma weed (Euphorbiahirta), Astragalus (Astragalus propinquus), Barberry (Berberisvulgaris), Belladonna (Atropa belladonna), Bilberry (Vacciniummyrtillus), Bitter leaf (Vernonia amygdalina), Black cohosh (Actaearacemosa), Blessed thistle (Cnicus benedictus), Burdock (Arctium lappa),Cat's claw (Uncaria tomentosa), Cayenne (Capsicum annuum), Celery (Apiumgraveolens), Chamomille (Matricaria recutita and Anthemis nobilis),Chaparral (Larrea tridentate), Chasteberry (Vitex agnus-castus), Chili(Capsicum frutescens), Coffee senna (Cassia occidentalis), Comfrey(Symphytum officinale), Cranberry (Vaccinium macrocarpon), Dandelion(Taraxacum officinale), Digitalis (Digitalis lanata), Dong quai(Angelica sinensis), Elderberry (Sambucus nigra), Ephedra (Ephedrasinica), Eucalyptus (Eucalyptus globulus), European Mistletoe (Viscumalbum), Evening primrose (Oenothera species), Fenugreek (Trigonellafoenum-graecum), Feverfew (Tanacetum parthenium), Flaxseed (Linumusitatissimum), Garlic (Allium sativum), Ginger (Zingiber officinale),Gingko (Gingko biloba), Ginseng (Panax ginseng and Panax quinquefolius),Goldenseal (Hydrastis canadensis), Guava (Psidium guajava), Hawthorn(Crataegus laevigata), Hoodia (Hoodia gordonii), Horse chestnut(Aesculus hippocastanum), Horsetail (Equisetum arvense), Jamaica dogwood(Piscidia erythrina or Piscidia piscipula), Kava (Piper methysticum),Konjac (Amorphophallus konjac), Lavender (Lavandula angustifolia),Licorice root (Glycyrrhiza glabra), Marigold (Calendula officinalis),Marsh mallow (Althaea officinalis), Milk thistle (Silybum marianum),Neem (Azadirachta indica), Noni (Morinda citrifolia), Papaya (Caricapapaya), Peppermint (Mentha×piperita), Purple coneflower (Echinaceapurpurea), Red clover (Trifolium pratense), Sage (Salvia officinalis),St. John's wort (Hypericum perforatum), Saw palmetto (Serenoa repens),Tea tree oil (Melaleuca alternifolia), Thunder God Vine (Tripterygiumwilfordii), Turmeric (Curcuma longa), Valerian (Valeriana officinalis),White willow (Salix alba), Yerba santa (Eriodictyon crassifolium), andYohimbe (Pausinystalia yohimbe).

In some embodiments, medical items include one or more medications. Infurther embodiments, the medical items include common medications suchas insulin, oral hypoglycemics, diuretics, potassium, antibiotics, ACEinhibitors, other anti-hypertensives, anti-arrhythmics, anti-coagulants,anti-inflammatories, analgesics, oral vaccines, injectable vaccines,bronchodilators, steroids, and oxygen.

In some embodiments, medications include one or more over-the-counter(OTC) medications. OTC medications are those that may be sold directlyto a consumer without a prescription from a healthcare professional. Infurther embodiments, OTC medications include, by way of non-limitingexamples, allergy prevention treatment medications, antacid medications,anticandial medications, antihistamines, antidiarrheal medications,anti-fungal medications, anti-itch lotions and creams, asthmamedications, cold sore/fever blister medications, contact lenssolutions, cough suppressants, decongestants, nasal decongestant andcold remedies, diaper rash ointments, eye drops for allergy or coldrelief, first aid supplies, hemorrhoid treatments, internal analgesicsand antipyretics, liniments, menstrual cycle medications, migrainemedications, motion sickness medications, nicotine gum or patches andsmoking cessation aids, pediculicides, poison ivy protectionmedications, toothache and teething pain medications, and wart removalmedications, not requiring a valid prescription.

In some embodiments, medications include one or more prescriptionmedications. Prescription medications are those that may be sold only toconsumers possessing a valid prescription. In some embodiments, a validprescription is issued by a Doctor of Medicine (MD), Doctor ofOsteopathic Medicine (DO), Physician Assistant (PA), Doctor of Optometry(OD), Doctor of Podiatry (DPM), Doctor of Naturopathic Medicine (NMD orND), Doctor of Veterinary Medicine (DVM), Doctor of Dental Surgery(DDS), Doctor of Dental Medicine (DMD), Medical Psychologist, NursePractitioner (NP) or other Advance Practice Nurse. In furtherembodiments, prescription medications include, by way of non-limitingexamples, ADHD medications, antacid medications (e.g., proton pumpinhibitors), antibiotics, anticoagulants, antifungals, antipsychotics,antivirals, asthma and COPD medications, cholesterol-loweringmedications (e.g., statins), contraceptives, depression medications,diabetes medications, erectile dysfunction medications, glaucomamedications, hormone therapy medications, hypertension medications,hypnotics, migraine medications, multiple sclerosis medications, nasalallergy medications, nausea medications, oral allergy medications,osteoporosis medications, overactive bladder medications, pain reliefmedications, rheumatoid arthritis medications, sedatives, and seizuremedications, requiring a valid prescription.

In some embodiments, a live, licensed healthcare provider monitors,supervises, or operates, an apparatus for dispensing one or more medicalitems. In some embodiments, the live, licensed healthcare provider is alicensed pharmacist. In other embodiments, the live, licensed healthcareprovider is in communication with a licensed pharmacist. In furtherembodiments, the live, licensed healthcare provider is responsible formonitoring, supervising, or operating the apparatus for dispensingmedical items uses a software module for telecommunications to contact,conference, or otherwise communicate with a licensed pharmacist. Instill further embodiments, the pharmacist assures the accuracy of theprescription and the medical items selected for dispensing to fill theprescription, reviews the prescription for recalls and druginteractions, etc. In some embodiments, the live, licensed healthcareprovider is in communication with pharmacy technician supervised by alicensed pharmacist.

In certain embodiments, disclosed herein are systems and devices forproviding remote medical diagnosis and therapy to subjects who have aninjury or illness that requires immediate care but is not serious enoughto warrant a visit to an emergency department. Accordingly, in someembodiments, the medical items are packaged to address the urgent needand contain a short-term supply of, for instance, medication. By way ofexample, in various embodiments, each package of medication containsless than a two-week supply of medication, less than a one-week supplyof medication, less than a four-day supply of medication, and less thana two-day supply of medication.

In some embodiments, the opening of the apparatus for dispensing one ormore medical items creates a signal identifying this event. In thisembodiment, a closed loop circuit will form a part of the opening wherethe one or more medical items will be dispensed. Upon opening, theclosed loop circuit will be broken creating an open circuit recognizedby the medical therapy device. In certain embodiments, the open circuitwill be recognized by the apparatus for dispensing one or more medicalitems and will send the information to the wireless enabled medicaltherapy device and allow the transmission of this information to thepharmacy and/or electronic medical record. In certain other embodiments,the medical therapy device will recognize the open circuit uponconnecting to the apparatus for dispensing one or more medical items andsend this information to the interfacing device (e.g., computer, tabletdevice, mobile phone, etc.) in order to update the patient's electronicmedical record.

In some embodiments, the inventory of medical items comprises one ormore therapeutic devices. In further embodiments, the therapeuticdevices include, by way of non-limiting examples, first aid supplies,hearing aids, optical aids, prostheses, mobility aids, continuouspositive airway pressure (CPAP) supplies, and the like. In someembodiments, the therapeutic devices include implements foradministering medications such as syringes, needles, inhalers, infusers,and vaporizers.

In some embodiments, the inventory of medical items comprises one ormore diagnostic devices. In further embodiments, the diagnostic devicesinclude, by way of non-limiting examples, blood chemistry testingdevices, hemoglobin testing devices, hematocrit testing devices, bloodglucose testing devices, blood cholesterol testing devices, bloodpressure testing devices, heart rate monitors, urinalysis devices, andsexually transmitted disease testing devices. In still furtherembodiments, the diagnostic devices include disposable parts andconsumable supplies for the devices disclosed herein including, by wayof non-limiting examples, test strips, reagents, solutions, and thelike.

In some embodiments, the inventory of medical items comprises one ormore diagnostic kits. In further embodiments, the diagnostic kitsinclude, by way of non-limiting examples, blood chemistry testing kits,hemoglobin testing kits, hematocrit testing kits, blood glucose testingkits, blood cholesterol testing kits, urinalysis kits, and sexuallytransmitted disease testing kits.

In some embodiments, the medical items are dispensed from an inventoryof medical items. The devices disclosed herein, in certain embodiments,vary widely in scale including, for example, portable devices, desktopdevices, kiosk devices, and stationary devices, and installationsAccordingly, a wide range of inventory sizes are suitable. In variousembodiments, an inventory of medical items includes, by way ofnon-limiting example, about 1 to about 10, about 10 to about 100, about100 to about 1,000, about 1,000 to about 10,000, about 10,000 to about100,000 or more medical items, including increments therein. In variousfurther embodiments, an inventory of medical items includes, by way ofnon-limiting example, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35,40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 200, 300, 400, 500or more types of medical items, including increments therein. In stillfurther various embodiments, an inventory of medical items includes, byway of non-limiting example, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25,30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100 or morevariations of each medical item in the inventory, including incrementstherein. In some embodiments, an apparatus for dispensing one or moremedical items includes features adapted to facilitate refilling,restocking, or resupplying the medical items or the inventory of medicalitems.

Devices for Providing Remote Medical Therapy

In some embodiments, a medical therapy device comprising at least oneconnector in communication with an apparatus for dispensing one or moremedical items from an inventory of medical items to a subject isincluded in a system for providing remote therapy to a subject. Infurther embodiments, the systems include one or more networked devicesthat include at least one processor, at least one memory device, and anoperating system configured to perform executable instructions. In stillfurther embodiments, the medical therapy device is in communication witha networked device. In further embodiments, a networked device includesa software module for establishing, maintaining, and conductingtelecommunications. In further embodiments, the systems disclosed hereininclude one or more biosensors. In still further embodiments, thebiosensors are remotely controlled. In further embodiments, a medicaltherapy device includes a software module for applying a diagnostic ortherapeutic analysis. In further embodiments, the medical therapy deviceincludes an apparatus for dispensing one or more medical items from aninventory of medical items to a subject. In still further embodiments, amedical therapy device includes a software module for providingfinancial insurance coverage to a subject. In still further embodiments,a medical therapy device includes a software module for providinginstantaneous encounter-specific financial insurance coverage with alevel of guarantee and an associated premium to a subject.

The devices described herein are characterized by scalability. Invarious embodiments, the devices described herein have a wide range ofsuitable scales and sizes. Those of skill in the art will recognize thatthe most suitable scale for a particular application varies with, forexample, the need for portability, tolerance of expense, the number andtype of features desired, the amount and number of days of therapyrequired, the volume of subjects served, and the like.

In some embodiments, the medical therapy device is linked to a networkeddevice that is a digital processing device and includes one or morehardware central processing units (CPU) that carry out the device'sfunctions. In further embodiments, the networked device includes anoperating system configured to perform executable instructions. Theoperating system is, for example, software, including programs and data,which manages the device's hardware and provides services for executionof applications. Those of skill in the art will recognize that suitableserver operating systems include, by way of non-limiting examples,FreeBSD, OpenBSD, NetBSD®, Linux, Apple® Mac OS X Server®, Oracle®Solaris®, Windows Server®, and Novell® NetWare®. Those of skill in theart will recognize that suitable personal computer operating systemsinclude, by way of non-limiting examples, Microsoft® Windows®, Apple®Mac OS X®, UNIX®, and UNIX-like operating systems such as GNU/Linux®. Insome embodiments, the operating system is provided by cloud computing.Those of skill in the art will also recognize that suitable mobile smartphone operating systems include, by way of non-limiting examples, Nokia®Symbian® OS, Apple® iOS®, Research In Motion® BlackBerry OS®, Google®Android®, Microsoft® Windows Phone® OS, Microsoft® Windows Mobile® OS,Linux®, and Palm® WebOS®.

In some embodiments, the medical therapy device is volatile memory andrequires power to maintain stored information. In some embodiments, thedevice is non-volatile memory and retains stored information when thedigital processing device is not powered. In further embodiments, thenon-volatile memory comprises flash memory. In some embodiments, thenon-volatile memory comprises dynamic random access memory (DRAM). Insome embodiments, the non-volatile memory comprises ferroelectric randomaccess memory (FRAM). In some embodiments, the non-volatile memorycomprises phase-change random access memory (PRAM). In furtherembodiments, the storage and/or memory capabilities are a combination ofdevices such as those disclosed herein.

In some embodiments, the medical therapy device includes a microphoneand/or speaker to capture or send voice or other sound input or output.In other embodiments, the device includes a video camera to capturemotion or visual input. In still further embodiments, the deviceincludes a visual component (e.g., LED, etc.) to output visualconfirmation. In still further embodiments, the device is a combinationof devices such as those disclosed herein. In some embodiments, theinput/output hardware and software is adapted to accommodate subjects,caregivers, healthcare providers, and other users with mental andphysical disabilities.

In some embodiments, the medical therapy device communicates with thenetworked device and/or the apparatus for dispensing one or more medicalitems from an inventory of medical items via wireless protocolsincluding, by way of non-limiting embodiments, infrared, Bluetooth,ZigBee, Wi-Fi, 3G/4G/LTE wireless protocols, RFID and NFC protocols. NFCprotocols may be used alone or in combination with other wirelessprotocols to remove the need for performing scans to identify thenetworked device, entering passcodes, and removing the risk ofestablishing a connection with the wrong networked device accommodatingthose with mental and physical disabilities. In still furtherembodiments, the medical therapy device communicates with the networkeddevice and/or the apparatus for dispensing one or more medical itemsfrom an inventory of medical items via a two-way pager system utilizinginternal transmitters. Those of skill in the art will recognize the mostappropriate components necessary to facilitate communication between themedical therapy device and the networked device and/or the apparatus fordispensing one or more medical items.

In some embodiments, Bluetooth, near field communication, or softwaredeveloped protocols will be integrated into the device to allow anetworked device, mobile apparatus and/or the apparatus for dispensingone or more medical items from an inventory of medical items and thedevice to send or receive information between one another. In order toallow communication between two specific entities so that the device isnot communicating with all mobile devices in the area, both devices needto be programmed with each other's specific radio address. UtilizingBluetooth, the device will broadcast its address, allowing the mobileapparatus, networked device, and/or the apparatus for dispensing one ormore medical items to recognize this address and ask the user forconfirmation of the use of this device. When this confirmation isreceived, the mobile apparatus, networked device, and/or the apparatusfor dispensing one or more medical items will send its unique address tothe device, thereby enabling communication between the two entities. Insome embodiments, utilized NFC allows both devices to read the RFID tagof each other and therefore allow communication by themselves, resultingin transfer of data without requiring the user to allow access.Additionally, since the device requires the mobile apparatus ornetworked device's software to enable connection to the cloudinformation system for prescription information, etc., the cloud may bepreloaded with the address of the device, allowing the mobile apparatusor networked device to retrieve the device's address upon login and thenautomatically “pair” the two allowing data transfer.

In accordance with the description herein, suitable networked devicesinclude (or are based on), by way of non-limiting examples, servercomputers, desktop computers, laptop computers, notebook computers,subnotebook computers, netbook computers, netpad computers, set-topcomputers, handheld computers, Internet appliances, mobile smartphones,tablet computers, personal digital assistants, cable television boxes,satellite television boxes, land phones, mobile phones, and video gameconsoles. Those of skill in the art will recognize that many smartphonesare suitable for use in the system described herein. Those of skill inthe art will also recognize that select televisions and select digitalmusic players with computer network connectivity are suitable for use inthe system described herein. Suitable tablet computers include thosewith booklet, slate, and convertible configurations, known to those ofskill in the art.

In some embodiments, the medical therapy device includes at least oneUSB connector. The at least one USB connector is reversibly retractablewithin a housing and extendable when needed to interface with anetworked device, biosensor, and/or apparatus for dispensing one or moremedical items. In further embodiments, the at least one USB connectorforms a part of the housing on a swivel to prevent damage to thecompatible USB port of the networked device, biosensor, and/or apparatusfor dispensing a medicament. In still further embodiments, connectionvia a USB cable facilitates connecting the medical therapy device to acompatible USB port of the networked device, biosensor, and/or apparatusfor dispensing a medicament. In still further embodiments, the medicaltherapy device facilitates communication and data transfer with atechnology device and/or the apparatus for dispensing one or moremedical items by a method selected from at least one member of the groupconsisting of: audio port, microphone jack, USB mini/micro-connector,USB Type A or Type B connector, infrared, Bluetooth, ZigBee, Wi-Fi,3G/4G/LTE wireless protocols, RFID, and NFC protocols.

In some embodiments, power is supplied to the medical therapy deviceand/or apparatus for dispensing medicaments via a USB interface with thenetworked device. In other embodiments, power is supplied to the medicaltherapy device and/or apparatus for dispensing medicaments directly froma wall socket, a phone land line or the like. In still furtherembodiments, the medical therapy device and/or apparatus for dispensingmedicaments is powered by a rechargeable lithium ion battery, battery orthe like.

In some embodiments, one or more components of a medical therapy deviceare reversibly separable. For example, in a particular embodiment, oneor more biosensors are reversibly separable from a device to increaseportability and facilitate access to subjects who may be immobile orisolated. In another particular embodiment, the telecommunicationscomponent is reversibly separable from the device to increaseportability and facilitate communication with subjects who may beimmobile or isolated. In another particular embodiment, the device isreversibly separable from the apparatus for dispensing medical items,again to increase portability, in cases where the dispensing apparatusis large, heavy, bulky, or fixed to a particular location. In otherembodiments, the components are not separable.

Referring to FIG. 3, in a particular embodiment, a connector device asdescribed herein includes at least one USB connector 30, 31. The USBconnector is constructed according to ordinary and known industrystandards and may be a standard Type A or Type B USB connector ormini-USB or micro-USB connector. In this embodiment, the device includesat least one confirmation component. The at least one confirmationcomponent optionally provides a visual confirmation, audibleconfirmation or a combination thereof. An audible confirmation component32 is configured to provide audible confirmation that the apparatus fordispensing one or more medical items from an inventory of medical itemsin communication with the device contains the correct medicamentidentified by the telemedical care provider for the subject. In analternative embodiment, a visual component 33 is configured to providevisual confirmation that the apparatus for dispensing one or moremedical items from an inventory of medical items in communication withthe device contains the correct medicament identified by the telemedicalcare provider for the subject.

Referring to FIG. 4, in a particular embodiment, a system for providingremote medical therapy to a subject in a healthcare encounter includes anetworked laptop computer 42 running software applications to facilitatecommunications between a telemedical care provider and a subject or asubject's caregiver. In this embodiment, the laptop is connected via aUSB interface to a connector device 40. The connector device 40 is alsoconnected to an apparatus for dispensing medicaments 41. The connectordevice, in this case, provides communication between the laptop computer42 and the apparatus for dispensing medicaments 41 such that a live,remote telemedical care provider can monitor and/or operate thedispensing apparatus.

The networked device may be server computers, desktop computers, laptopcomputers, notebook computers, sub-notebook computers, netbookcomputers, netpad computers, set-top computers, handheld computers,Internet appliances, mobile smartphones, tablet computers, personaldigital assistants, television or satellite cable boxes, land phones,mobile phones, and video game consoles. Additionally, the networkeddevice may be configured to include diagnostic modules that areremovable and interchangeable such that the networked device isoptionally configured for a wide range of environments, end users,and/or patient populations by selecting and installing particulardiagnostic modules.

Referring to FIG. 5, in a particular embodiment, a system for providingremote medical therapy to a subject in a healthcare encounter includes anetworked laptop computer 52 running software applications to facilitatecommunications between a telemedical care provider and a subject or asubject's caregiver. In this embodiment, the laptop is in communicationwith the laptop computer 52 and an apparatus for dispensing medicaments51 via a connector device 50 utilizing a wireless communicationsprotocol. The connector device, in this case, provides communicationbetween the laptop computer 52 and the apparatus for dispensingmedicaments 51 such that a live, remote telemedical care provider canmonitor and/or operate the dispensing apparatus. Wirelessly connectedcomponents of the system increase portability and facilitate access tosubjects. In this embodiment, the device is optionally in communicationwith the medicament dispensing apparatus 51 and networked device 52 viaa NFC protocol or a wi-fi protocol.

In many embodiments, NFC connected devices allow rapid configuration andre-configuration based on health and economic risks faced by aparticular subject, family, or population. In some embodiments, themedical therapy device includes a RFID reader that may contain a barcodereader. The RFID reader included with the medical therapy device may bepowered by a cable or battery and pings a RFID tag included in theapparatus for dispensing one or more medical items, which includesstandard prescription labeling, including drug name, dosage, expirationdate, lot number, and the like. The RFID transponder included in theapparatus for dispensing one or more medical items for transmittinginformation to the RFID reader included with the medical therapy devicemay be a passive or active transponder operating in the low frequency,high frequency, or ultra-high frequency domain. In alternativeembodiments, the RFID reader is included in the apparatus for dispensingone or more medical items and the RFID tag included in the medicaltherapy device.

In some embodiments, one or more components of a medical therapy deviceare non-portable or fixed in a stationary installation. For example, ina particular embodiment, one or more biosensors are fixed in astationary installation to increase access to subjects at a centralizedlocation. In another particular embodiment, the telecommunicationscomponent is fixed in a stationary installation to increase access tosubjects at a centralized location. In another particular embodiment, anapparatus for dispensing medical items is fixed in a stationaryinstallation to increase access to subjects at a centralized location.

Referring to FIGS. 4 and 5, in particular embodiments, an apparatus fordispensing one or more medical items to a subject in a healthcareencounter is operated remotely by a live, licensed healthcare provider.In other embodiments, an apparatus for dispensing one or more medicalitems to a subject operates in an emergency mode and dispenses one ormore medical items autonomously (e.g., without remote operation by alive healthcare provider). In further embodiments, an apparatus fordispensing one or more medical items operating in an emergency modeutilizes a module for risk assessment and/or diagnostic/therapeuticanalysis to guide dispensing determinations. In still furtherembodiments, an apparatus for dispensing one or more medical itemsoperating in an emergency mode activates the emergency response system(e.g., police, fire, EMS, etc.).

Referring to FIG. 6, in a particular embodiment, a device for providingremote medical therapy to a subject in a healthcare encounter includes aUSB mini/micro-connector 60 for connecting to an apparatus fordispensing medical items; a phone jack 61 for connecting to a land linetelephone, cable box, satellite box or the like; a card reader slot 62for reading a magnetic stripe (also called a magstripe) on a card and/orthe apparatus for dispensing one or more medical items. The card readerslot 62 may be used to read a magnetic stripe from a credit card,insurance card, membership card, or the like. A USB connector (type A,type B, or mini/micro-connector) 63 allows a connection to a networkedtechnology device. Additionally, the device includes an output jack 64for communicating with a mobile device via a microphone port or audiojack located on a mobile device. In some embodiments, the technologydevice includes the necessary software for decoding the informationcontained within the magnetic stripe card and swiped in the card readerslot 62. In some embodiments, the card reader slot 62, reads a magneticstripe contained on the apparatus for dispensing one or more medicalitems from an inventory of medical items including information such asstandard prescription labeling, including drug name, dosage, expirationdate, lot number, and the like. In various embodiments, one or more ofthe connectors (60, 63, 64) is reversibly retractable within thehousing. In various embodiments, one or more of the connectors (60, 64)is swivels about an axis with respect to the housing to allow it to foldinto the housing. In such embodiments with retractable or foldingconnectors, the device is portable and easy to store.

Other relevant information contained on the magnetic stripe on theapparatus for dispensing one or more medical items includes patientidentifying information, insurance information, and/or servicemembership information. Membership information may include suchinformation as identification of membership in healthcare services,pharmaceutical services including retail pharmacy memberships and thelike. In some embodiments, the card reader slot forms a part of theapparatus for dispensing one or more medical items from an inventory ofmedical items. In one embodiment, the magnetic stripe may be located onthe medical therapy device and swiped through the slot forming a part ofthe apparatus for dispensing one or more medical items and includes suchinformation as standard prescription labeling, including drug name,dosage, expiration date, lot number, patient identifying information,insurance information, membership information, and the like. Themagnetic stripe may be retractable within the medical therapy device orthe apparatus for dispensing one or more medical items.

Referring to FIG. 7, in a particular embodiment, an apparatus fordispensing one or more medical items to a subject in a healthcareencounter 70 in encased in an opaque, protective sleeve 71 and includesa magnetic stripe 72 and a mini-USB type B connector 73. In thisembodiment, the protective sleeve 71 provides one layer of childresistance by preventing opening of the apparatus and access to themedicaments therein. Further in this embodiment, the magnetic stripe 72provides information about, for example, the medicaments to a technologydevice or a connector device fitted with a magnetic stripe reader. Alsoin this embodiment, the USB connector 73 provides communication with atechnology device.

Referring to FIG. 8, in a particular embodiment, an apparatus fordispensing one or more medical items to a subject in a healthcareencounter 70 is removed from the opaque, protective sleeve (not shown)and includes a magnetic stripe 72 and a mini-USB type B connector 73. Inthis embodiment, the apparatus includes a mechanism 81 that allowsopening and closing of a hinged lid 80 and access to the medicaments 82therein. In this embodiment, the lid opening/closing mechanism 81provides another layer of child resistance by preventing opening of theapparatus and access to the medicaments therein.

Referring to FIG. 9, in a particular embodiment, an apparatus fordispensing one or more medical items to a subject in a healthcareencounter 70 is removed from the opaque, protective sleeve (not shown)and includes a magnetic stripe 72. In this embodiment, the apparatusincludes a mechanism 81 that has been released and the hinged lid 80opened to allow access to the medicaments 82 therein.

Referring to FIG. 10, in a particular embodiment, a system fordispensing one or more medical items to a subject in a healthcareencounter includes a technology device 104, in this case a mobilesmartphone. The system also includes a connector device 100 with threedifferent connectors: 1) a mini-USB connector 101, 2) a USB type Aconnector 102, and 3) an audio jack connector 103. In this embodiment,the smartphone is in communication with the connector device by couplingvia the audio jack. The connector device further includes a magneticcard reader 105 for reading information from a variety of sourcesincluding, for example, a subject ID card, a financial transaction card,a medical insurance card, and an apparatus for dispensing medical itemsto a subject. The system also includes an apparatus for dispensing oneor more medical items to a subject in a healthcare encounter. In thiscase, the apparatus is in a protective sleeve 71 and includes a magneticstripe 72 for identifying, for example, the medical items contained inthe apparatus. In this embodiment, when the apparatus is swiped throughthe magnetic stripe reader 105 of the connector device 100 thetechnology device 104 is utilized to allow verification that the medicalitem is appropriate for the subject. Remote verification that themedical item is appropriate for the subject in the healthcare encounterprovides yet another layer of child resistance and accident/abuseprevention.

In some embodiments, confirmation of an appropriate apparatus fordispensing medical items for the subject in the healthcare encounter isprovided via one or more confirmation components of the connectordevice. In some embodiments, the networked technology device is furtherconfigured to allow identification of the subject, collection ofbiosensor data, performance of audio/video conferencing between thesubject and one or more live, remote telemedical care providers. Infurther embodiments, a lid opening/closing mechanism is remotelymonitored and/or operated by a live, remote telemedical care provider.

Referring to FIG. 11, in a particular embodiment, a system fordispensing one or more medical items to a subject in a healthcareencounter includes a connector device 100 with two differentconnectors: 1) a mini-USB connector and 2) a USB type A connector 102.The system also includes an apparatus for dispensing one or more medicalitems to a subject in a healthcare encounter 70. In this case, theapparatus is in a protective sleeve 71 and includes a mini-USB connector73 and a magnetic stripe 72 for identifying, for example, the medicalitems contained in the apparatus. In this embodiment, the apparatus 70is in communication with the connector device 100 by coupling via themini-USB connector 73. In this embodiment, the connector device isfurther available for connection to a networked technology device via afree USB connector 102.

The devices and systems disclosed herein offer multiple layers ofchildproofing and child resistance. In various embodiments, thechildproofing mechanisms include, by way of non-limiting examples, anopaque protective sleeve that conceals the medical items within thedispensing apparatus, a protective child-resistant wrapper over theapparatus, a tamper-proof opening/closing mechanism for the dispensingapparatus, and electronic verification that the medical items within thedispensing apparatus are appropriate for a particular subject in ahealthcare encounter.

Referring to FIG. 12, in a particular embodiment, an apparatus fordispensing one or more medical items to a subject is a disposable devicedesigned for individual use. In this embodiment, an apparatus fordispensing one or more medical items includes a locking cap 120,unlocked remotely by a healthcare provider (e.g., pharmacist, nurse,physician, etc.). The locking mechanism is any form of locking mechanismknown to those of ordinary skill in the art wherein the lockingmechanism is controlled remotely. Further in this embodiment, theapparatus includes standard prescription labeling 121, including drugname, dosage, expiration date, lot number, and the like. To facilitatecommunication via USB with the device disclosed herein, the apparatusincludes a USB interface 122, of a standard USB connector Type A or B orMini/Micro-connector. The prescribed medicaments are housed individuallyor in unit dose packaging in a suitable container 123 and of a suitablesize based on the particular type of prescribed medicament and amountand duration of therapy prescribed.

Non-Transitory Computer Readable Storage Medium

In some embodiments, the devices, systems, software, and methodsdisclosed herein include one or more non-transitory computer readablestorage media encoded with a program including instructions executableby the operating system of an optionally networked digital processingdevice. In further embodiments, a computer readable storage medium is atangible component of a digital processing device. In still furtherembodiments, a computer readable storage medium is optionally removablefrom a digital processing device. In some embodiments, a computerreadable storage medium includes, by way of non-limiting examples,CD-ROMs, DVDs, flash memory devices, solid state memory, magnetic diskdrives, magnetic tape drives, optical disk drives, cloud computingsystems and services, and the like. In some cases, the program andinstructions are permanently, substantially permanently,semi-permanently, or non-transitorily encoded on the media.

Computer Program

In some embodiments, the devices, systems, software, and methodsdisclosed herein include at least one computer program, or use of thesame. A computer program includes a sequence of instructions, executablein the digital processing device's CPU, written to perform a specifiedtask. Computer readable instructions may be implemented as programmodules, such as functions, objects, Application Programming Interfaces(APIs), data structures, and the like, that perform particular tasks orimplement particular abstract data types. In light of the disclosureprovided herein, those of skill in the art will recognize that acomputer program may be written in various versions of variouslanguages.

The functionality of the computer readable instructions may be combinedor distributed as desired in various environments. In some embodiments,a computer program comprises one sequence of instructions. In someembodiments, a computer program comprises a plurality of sequences ofinstructions. In some embodiments, a computer program is provided fromone location. In other embodiments, a computer program is provided froma plurality of locations. In various embodiments, a computer programincludes one or more software modules. In various embodiments, acomputer program includes, in part or in whole, one or more webapplications, one or more mobile applications, one or more standaloneapplications, one or more web browser plug-ins, extensions, add-ins, oradd-ons, or combinations thereof.

Web Application

In some embodiments, a computer program includes a web application. Inlight of the disclosure provided herein, those of skill in the art willrecognize that a web application, in various embodiments, utilizes oneor more software frameworks and one or more database systems. In someembodiments, a web application is created upon a software framework suchas Microsoft®.NET or Ruby on Rails (RoR). In some embodiments, a webapplication utilizes one or more database systems including, by way ofnon-limiting examples, relational, non-relational, object oriented,associative, and XML database systems. In further embodiments, suitablerelational database systems include, by way of non-limiting examples,Microsoft® SQL Server, mySQL™, and Oracle®. Those of skill in the artwill also recognize that a web application, in various embodiments, iswritten in one or more versions of one or more languages. A webapplication may be written in one or more markup languages, presentationdefinition languages, client-side scripting languages, server-sidecoding languages, database query languages, or combinations thereof. Insome embodiments, a web application is written to some extent in amarkup language such as Hypertext Markup Language (HTML), ExtensibleHypertext Markup Language (XHTML), or eXtensible Markup Language (XML).In some embodiments, a web application is written to some extent in apresentation definition language such as Cascading Style Sheets (CSS).In some embodiments, a web application is written to some extent in aclient-side scripting language such as Asynchronous Javascript and XML(AJAX), Flash® Actionscript, Javascript, or Silverlight®. In someembodiments, a web application is written to some extent in aserver-side coding language such as Active Server Pages (ASP),ColdFusion®, Perl, Java™, JavaServer Pages (JSP), Hypertext Preprocessor(PHP), Python™, Ruby, Tcl, Smalltalk, WebDNA®, or Groovy. In someembodiments, a web application is written to some extent in a databasequery language such as Structured Query Language (SQL). In someembodiments, a web application integrates enterprise server productssuch as IBM® Lotus Domino®. In some embodiments, a web applicationincludes a media player element. In various further embodiments, a mediaplayer element utilizes one or more of many suitable multimediatechnologies including, by way of non-limiting examples, Adobe® Flash®,HTML 5, Apple® QuickTime®, Microsoft® Silverlight®, Java™, and Unity

Mobile Application

In some embodiments, a computer program includes a mobile applicationprovided to a mobile digital processing device. In some embodiments, themobile application is provided to a mobile digital processing device atthe time it is manufactured. In other embodiments, the mobileapplication is provided to a mobile digital processing device via thecomputer network described herein.

In view of the disclosure provided herein, a mobile application iscreated by techniques known to those of skill in the art using hardware,languages, and development environments known to the art. Those of skillin the art will recognize that mobile applications are written inseveral languages. Suitable programming languages include, by way ofnon-limiting examples, C, C++, C#, Objective-C, Java™, Javascript,Pascal, Object Pascal, Python™, Ruby, VB.NET, WML, and XHTML/HTML withor without CSS, or combinations thereof.

Suitable mobile application development environments are available fromseveral sources. Commercially available development environmentsinclude, by way of non-limiting examples, AirplaySDK, alcheMo,Appcelerator®, Celsius, Bedrock, Flash Lite, .NET Compact Framework,Rhomobile, and WorkLight Mobile Platform. Other development environmentsare available without cost including, by way of non-limiting examples,Lazarus, MobiFlex, MoSync, and Phonegap. Also, mobile devicemanufacturers distribute software developer kits including, by way ofnon-limiting examples, iPhone and iPad (iOS) SDK, Android™ SDK,BlackBerry® SDK, BREW SDK, Palm® OS SDK, Symbian SDK, webOS SDK, andWindows® Mobile SDK.

Those of skill in the art will recognize that several commercial forumsare available for distribution of mobile applications including, by wayof non-limiting examples, Apple® App Store, Android™ Market, BlackBerry®App World, App Store for Palm devices, App Catalog for webOS, Windows®Marketplace for Mobile, Ovi Store for Nokia® devices, Samsung® Apps, andNintendo® DSi Shop.

Standalone Application

In some embodiments, a computer program includes a standaloneapplication, which is a program that is run as an independent computerprocess, not an add-on to an existing process, e.g., not a plug-in.Those of skill in the art will recognize that standalone applicationsare often compiled. A compiler is a computer program(s) that transformssource code written in a programming language into binary object codesuch as assembly language or machine code. Suitable compiled programminglanguages include, by way of non-limiting examples, C, C++, Objective-C,COBOL, Delphi, Eiffel, Java™, Lisp, Python™, Visual Basic, and VB .NET,or combinations thereof. Compilation is often performed, at least inpart, to create an executable program. In some embodiments, a computerprogram includes one or more executable complied applications.

Software Modules

In some embodiments, the devices, systems, software, and methodsdisclosed herein include software, server, and/or database modules, oruse of the same. In view of the disclosure provided herein, softwaremodules are created by techniques known to those of skill in the artusing machines, software, and languages known to the art. The softwaremodules disclosed herein are implemented in a multitude of ways. Invarious embodiments, a software module comprises a file, a section ofcode, a programming object, a programming structure, or combinationsthereof. In further various embodiments, a software module comprises aplurality of files, a plurality of sections of code, a plurality ofprogramming objects, a plurality of programming structures, orcombinations thereof. In various embodiments, the one or more softwaremodules comprise, by way of non-limiting examples, a web application, amobile application, and a standalone application. In some embodiments,software modules are in one computer program or application. In otherembodiments, software modules are in more than one computer program orapplication. In some embodiments, software modules are hosted on onemachine. In other embodiments, software modules are hosted on more thanone machine. In further embodiments, software modules are hosted oncloud computing platforms. In some embodiments, software modules arehosted on one or more machines in one location. In other embodiments,software modules are hosted on one or more machines in more than onelocation.

Databases

In some embodiments, the devices, systems, software, and methodsdisclosed herein include one or more databases, or use of the same. Inview of the disclosure provided herein, those of skill in the art willrecognize that many databases are suitable for storage and retrieval ofsubject, medication, provider, and/or insurance information. In variousembodiments, suitable databases include, by way of non-limitingexamples, relational databases, non-relational databases, objectoriented databases, object databases, entity-relationship modeldatabases, associative databases, and XML databases. In someembodiments, a database is internet-based. In further embodiments, adatabase is web-based. In still further embodiments, a database is cloudcomputing-based. In other embodiments, a database is based on one ormore local computer storage devices.

EXAMPLE

The following illustrative example is representative of an embodiment ofthe devices, systems, software, and methods described herein and are notmeant to be limiting in any way.

Live, Remote, Adjunct Triage

A 25-year-old female subject, living in Texas, is experiencing symptomsassociated with X. The nearest medical facility is at least a fewhundred miles away. Previously, the female was seen by her primary carephysician who identified, based on a risk profile analysis, thestatistical likelihood of the patient experiencing symptoms associatedwith X in the near future. Upon the occurrence of the symptoms, thefemale, using a networked device, connects to a live, remote, adjunctprovider. The provider, a physician assistant (PA) located inCalifornia, is credentialed by the researcher's healthcare provider whoverified the PA's education, training, certifications, references,prescription license, malpractice insurance coverage, and state licenseand state of licensure. The PA asks basic questions about the subject'ssymptoms and examines the subject visually. To gather additionalinformation, the PA instructs the subject to use the biometric sensorequipped in her networked device. The biometric sensor measures thesubject's vital signs and other biometric data such as her bodytemperature, heart rate, blood pressure, and respiratory rate. The PAobtains the subject's consent to access her electronic health records.Using a software program, which is updated regularly to meet applicablelegal requirements, the PA accesses the subject's medical history,medication history, family history, and other relevant information.Based on the information gathered by the PA, the subject is instructedto connect her medical therapy device and the apparatus for dispensingthe pre-prescribed medicaments for X to the networked device. Theapparatus is confirmed visually as containing the pre-prescribedmedications for X and remotely unlocked by the PA.

While preferred embodiments of the present invention have been shown anddescribed herein, it will be obvious to those skilled in the art thatsuch embodiments are provided by way of example only. Numerousvariations, changes, and substitutions will now occur to those skilledin the art without departing from the invention. It should be understoodthat various alternatives to the embodiments of the invention describedherein may be employed in practicing the invention.

What is claimed is:
 1. A device comprising a memory, the device furthercomprising: a. a housing; b. at least one means for communicating with anon-refillable, disposable apparatus for dispensing one or more medicalitems from a short-term inventory of medical items, the inventory ofmedical items risk profiled based on probability calculation of healthor economic risk to a subject in advance of need for the medical items,the short-term inventory of medical items consisting essentially of aless than one week supply of a medication; c. at least one means forcommunicating with a technology device; and d. a software moduleenabling communications between the apparatus for dispensing one or moremedical items from a short-term inventory of medical items and thetechnology device, the software module enabling communicationsconfigured to receive billing information from the means forcommunicating with the apparatus for dispensing one or more medicalitems upon development of need for the medical items by the subject andtransmit the billing information via the technology device to effectuatebilling for the one or more medical items upon development of need forthe medical items.
 2. The device of claim 1, further comprising amagnetic stripe reader.
 3. The device of claim 2, wherein the at leastone means for communicating with an apparatus for dispensing one or moremedical items from an inventory of medical items is a magnetic stripereader.
 4. The device of claim 1, wherein the at least one means forcommunicating with an apparatus for dispensing one or more medical itemsfrom an inventory of medical items is a connector selected from: dataport, audio jack, microphone jack, Ethernet, FireWire, mini-USB,micro-USB, USB Type A, and USB Type B.
 5. The device of claim 4, whereinthe connector is reversibly retractable within the housing or swivelsabout an axis with respect to the housing.
 6. The device of claim 1,wherein the at least one means for communicating with an apparatus fordispensing one or more medical items from an inventory of medical itemsis a wireless interface selected from: Bluetooth, ZigBee, Wi-Fi, nearfield communication, radio-frequency identification, and infrared. 7.The device of claim 1, further comprising a confirmation component, theconfirmation component indicating if a correct apparatus for dispensingone or more medical items is in communication with the device.
 8. Thedevice of claim 7, wherein the confirmation component provides visualconfirmation, audible confirmation, tactile confirmation, or acombination thereof.
 9. The device of claim 1, wherein the technologydevice is a computer, a mobile device, a hard wired telephone, a set topbox, an internet appliance, or medical diagnostic device.
 10. The deviceof claim 1, wherein the technology device is a networked deviceincluding a software module for securely accessing one or moreelectronic health records for the subject.
 11. The device of claim 1,wherein the at least one means for communicating with a technologydevice is a connector selected from: data port, audio jack, microphonejack, Ethernet, FireWire, mini-USB, micro-USB, USB Type A, and USB TypeB.
 12. The device of claim 11, wherein the connector is reversiblyretractable within the housing or swivels about an axis with respect tothe housing.
 13. The device of claim 1, wherein the at least one meansfor communicating with a technology device is a wireless interfaceselected from: Bluetooth, ZigBee, Wi-Fi, near field communication,radio-frequency identification, and infrared.
 14. The device of claim 1,further comprising a software module for remote monitoring of the deviceby a telemedical care provider in a healthcare encounter.
 15. The deviceof claim 14, wherein the telemedical care provider is selected from thegroup consisting of: a physician, a pharmacist, a dentist, a physicianassistant, a nurse practitioner, a registered nurse, a pharmacist, achiropractor, an emergency medical technician, a licensed practicalnurse, a certified ultrasound technician, a psychologist, a socialworker, a military medic, a physical therapist, an occupationaltherapist, a speech therapist, a radiology technician, a cardiaccatheterization technician, a clinical pathology laboratory technician,a medical aesthetician, a licensed medical technologist, a toxicologistconsultant, a credentialed medical legal consultant, a credentialedhospital operations administrator, veterinarian or a veterinary nurse,assistant, or technician.
 16. The device of claim 14, wherein thetelemedical care provider is the subject's primary care physician. 17.The device of claim 16, wherein the subject's primary care physicianselects at least one adjunct healthcare provider identified or selectedbased on one or more of: type of patient's condition, severity ofpatient's condition, patient's insurance eligibility, and availabilityof one or more adjunct healthcare providers.
 18. The device of claim 17,wherein the at least one adjunct healthcare provider is credentialed bythe subject's primary care provider to provide: remote diagnosis andtherapy, telemedical services, urgent care services, outpatientservices, acute care services, pharmacy services, insurance services tothe subject, or a combination thereof.
 19. The device of claim 1,further comprising a software module for identifying a subject.
 20. Thedevice of claim 1, further comprising a biosensor.
 21. The device ofclaim 1, wherein the inventory of medical items is risk profiled bydetermining a statistical level of likelihood that the items will beneeded within 2 years, within 1 year, within 6 months, within 1 month,within 2 weeks, within 1 week, or within 1 day.
 22. The device of claim21, wherein risk profiling analysis comprises performing statisticalanalysis, performing probability calculations, making recommendations,and making outcome predictions to predict a health or economic outcomeof a patient or therapy, wherein said prediction is real-time,individualized, and probabilistic-based and uses historic, peer-reviewedhealth or economic data and emerging health or economic data.
 23. Thedevice of claim 1, wherein the inventory of medical items comprisesitems that require a prescription from a licensed healthcare provider.24. A system comprising: a. a non-refillable, disposable apparatus fordispensing one or more medical items from a short-term inventory ofmedical items, the inventory of medical items risk profiled based onprobability calculation of future health or economic risk to a subjectin advance of need for the medical items, the short-term inventory ofmedical items consisting essentially of a less than one week supply of amedication; and b. a connector device comprising: i. at least one meansfor communicating with the apparatus for dispensing one or more medicalitems from a short-term inventory of medical items; ii. at least onemeans for communicating with a technology device; and iii. a softwaremodule enabling communications between the apparatus for dispensing oneor more medical items from a short-term inventory of medical items andthe technology device, the software module enabling communicationsconfigured to receive billing information from the means forcommunicating with the apparatus for dispensing one or more medicalitems upon development of need for the medical items by the subject andtransmit the billing information via the technology device to effectuatebilling for the one or more medical items upon development of need forthe medical items.
 25. The system of claim 24, wherein the apparatus fordispensing one or more medical items from an inventory of medical itemscomprises a magnetic stripe reader.
 26. The system of claim 24, whereinthe connector device or the technology device comprises a softwaremodule for providing instantaneous encounter-specific financialinsurance coverage, wherein said insurance includes a level of guaranteeand an associated premium.
 27. The system of claim 24, wherein theapparatus for dispensing one or more medical items from an inventory ofmedical items comprises one or more tamper-proof or child-proofelements.
 28. The system of claim 27, wherein the apparatus fordispensing one or more medical items from an inventory of medical itemscomprises one or more of: a removable, opaque sleeve; a tamper-proof orchild-proof opening mechanism; a tamper-proof or child-proof protectivewrapper; and remote monitoring by a live, remote telemedical careprovider.
 29. A device comprising a memory, the device furthercomprising: a. a housing; b. a communications connection forcommunicating with a non-refillable, disposable apparatus for dispensingone or more medical items from a short-term inventory of medical items,the inventory of medical items risk profiled based on probabilitycalculation of future health or economic risk to a subject in advance ofneed for the medical items, the short-term inventory of medical itemsconsisting essentially of a less than one week supply of a medication;c. a communications connection for communicating with a technologydevice, the technology device comprising a software module for remotemonitoring of the device by a telemedical care provider; d. a softwaremodule enabling communications between a connected apparatus fordispensing one or more medical items from an inventory of medical itemsand a connected technology device, the software module enablingcommunications configured to receive billing information from thecommunications connection for communicating with the apparatus fordispensing one or more medical items upon development of need for themedical items and transmit the billing information via the technologydevice to effectuate billing for the one or more medical items upondevelopment of need for the medical items; and e. a confirmationcomponent, the confirmation component indicating if the correctapparatus for dispensing one or more medical items is in communicationwith the device.